Full-Time

Senior Clinical Strategist

Posted on 11/30/2025

Deadline 12/18/25
CVS Health

CVS Health

10,001+ employees

Healthcare, insurance, PBM, and retail pharmacy

Compensation Overview

$95.7k - $206.2k/yr

+ Bonus + Commission + Short-term Incentive

Company Historically Provides H1B Sponsorship

Pennsylvania, USA + 3 more

More locations: Jackson Township, NJ, USA | Waterbury, CT, USA | New York, NY, USA

Remote

Category
Business & Strategy (2)
,
Requirements
  • Registered Nurse with active and unrestricted license in state the candidate resides
  • 4+ years of case management experience
  • 3+ years clinical experience
  • 1+ year leadership or supervisory experience
  • Residency in New York, New Jersey, Eastern Pennsylvania or Western Connecticut
Responsibilities
  • Establish trusting relationships with provider partners to promote open communication
  • Serve as clinical expert on actionable opportunities related to care management, gap closure, workflow discussions, and partnering with case manager supervisor/manager and case managers
  • Serve as internal and external liaison and clinical resource, interpreting data and educating regarding how to utilize data for population health performance improvement
  • Strategize with subject matter experts and clinical teams both internally and externally to drive outcomes and improve efficiencies
  • Coordinate and conduct clinically focused meetings to identify opportunities, target and prioritize goals and interventions to close gaps in care and achieve optimal stars performance
  • Collaboratively work across multiple functions and/or segments to obtain agreement from all impacted parties
  • Collaborate with Engagement Managers, Local Market Team, Data Team, Medical Operations and others on initiatives for Stars/quality improvement
Desired Qualifications
  • Strong communication and interpersonal skills
  • Proven track record in meeting project milestones and negotiating for resources
  • Proven negotiation skills
  • Proven project management skills
  • Proven success while working in a matrixed environment
  • 1+ year managed care experience
  • Creating accountability, developing and executing strategy and driving change
  • 4+ years of Outlook experience
  • 4+ years of Microsoft PowerPoint experience
  • 4+ years of Microsoft Excel experience
  • 1+ year SharePoint experience
  • Bachelor's Degree preferred

CVS Health operates as a diversified health services company in the United States, organized into Health Care Benefits, Pharmacy & Consumer Wellness, and Health Services. Its offerings include medical insurance products, retail and mail-order prescription drugs, and pharmacy benefit management (PBM) services, all connected through its integrated platform. By combining insurance, retail pharmacy, PBM, and health solutions, CVS Health coordinates care and controls costs across touchpoints for individuals, employers, and government programs. The company aims to lower health care costs while improving access and health outcomes for customers.

Company Size

10,001+

Company Stage

IPO

Headquarters

Woonsocket, Rhode Island

Founded

1963

Simplify Jobs

Simplify's Take

What believers are saying

  • Q1 2026 revenue exceeded $100B, up 6% year-over-year.
  • Medical benefit ratio improved to 84.6%, signaling better cost management.
  • Pharmacy-only locations in underserved areas drive medication access expansion.

What critics are saying

  • Amazon Pharmacy captures 20% urban market share with next-day delivery.
  • FTC settlement forces PBM margin cuts of 15-20% through transparency.
  • State-level spread pricing bans eliminate $2-3B annual pharmacy revenue.

What makes CVS Health unique

  • Integrated model combines insurance, pharmacy, and primary care clinics uniquely.
  • Over 800 MinuteClinic locations and 24/7 virtual care nationwide.
  • Aetna serves 26 million medical members with broad health plans.

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Benefits

Health Insurance

Dental Insurance

Vision Insurance

Life Insurance

Disability Insurance

401(k) Retirement Plan

Company Equity

Wellness Program

Professional Development Budget

Paid Vacation

Paid Holidays

Company News

PR Newswire
Mar 30th, 2026
CVS opens first pharmacy-only location in Chicago, plans nearly 20 this year

CVS Health has opened its first pharmacy-only location in Chicago, part of plans to launch nearly 20 such sites across the US this year. The 3,000-square-foot store at 2628 West Pershing Road features a full-service pharmacy with selected over-the-counter products. The pharmacy-only format is designed to increase access to medications, immunizations and pharmacist consultations in underserved communities. Additional locations are planned for Houston, Roxbury, Detroit and Brooklyn in 2026, alongside more than 40 traditional CVS Pharmacy stores. The move responds to consumer preferences, with CVS's 2025 research showing 80% of patients prefer face-to-face pharmacy care and 48% would switch pharmacies if limited to digital-only options. The company opened its first pharmacy-only site in Birmingham, Alabama, late last year.

Yahoo Finance
Mar 26th, 2026
CVS settles FTC insulin pricing probe as regulatory scrutiny of pharmacy benefit manager intensifies

CVS Health has reached a proposed settlement with the Federal Trade Commission over insulin pricing practices at its Caremark pharmacy benefit manager unit. The company also declared a quarterly dividend of $0.665 per share, payable on 4 May 2026. The settlement places CVS's pharmacy benefit management model under increased regulatory scrutiny regarding drug cost transparency. The company's investment narrative centres on its integrated model across insurance, pharmacy and care delivery, with near-term focus on restoring profitability in healthcare delivery and PBM services. CVS recently appointed former Elevance Health CFO John E. Gallina to its board as an audit committee financial expert. The company's narrative projects $445.5 billion revenue and $10.2 billion earnings by 2029, implying a fair value of $96.50 per share.

Yahoo Finance
Mar 23rd, 2026
Bernstein upgrades CVS Health to Outperform with $94 price target amid Medicare Advantage turnaround

Bernstein analyst Lance Wilkes upgraded CVS Health to "Outperform" from "Market Perform" on 12 March, raising the price target to $94 from $91. The upgrade reflects the company's attractive exposure to the Medicare Advantage turnaround and expectations of stable earnings in its pharmacy and pharmacy benefit manager businesses following reforms. Wilkes cited the PBM bill passage and the Federal Trade Commission settlement with Cigna as clearing events for the stock. Separately, CVS Health announced a strategic partnership with Google Cloud focused on reimagining healthcare experiences through its new health technology subsidiary, Health100, which will offer AI-powered healthcare services. CVS Health operates as a diversified healthcare company combining insurance, pharmacy benefit management, retail pharmacies and clinical services across the United States.

Yahoo Finance
Mar 13th, 2026
CVS Health's Aetna unit pays $117.7M to settle Medicare Advantage fraud allegations

Aetna, a CVS Health subsidiary, has agreed to pay $117.7 million to the US Department of Justice to settle allegations that it submitted inaccurate diagnosis codes for Medicare Advantage members to increase reimbursements. The settlement resolves longstanding False Claims Act allegations related to the Medicare Advantage programme. CVS Health shares recently closed at $76.07, down 5.1% year-to-date, though up 20.1% over the past year. The settlement is material for the company, which has thin net margins of 0.4% and debt not well covered by operating cash flow. The agreement highlights compliance risks in CVS Health's government-facing insurance operations, a central part of its Medicare Advantage business. Analysts' average target price stands at $96.50, approximately 27% above current levels.

Yahoo Finance
Mar 7th, 2026
Alphabet faces wrongful death lawsuit over Gemini AI chatbot while expanding healthcare partnership with CVS

Alphabet faces a wrongful death lawsuit alleging its Gemini AI chatbot contributed to a user's suicide, reportedly the first legal case directly linking Google's AI tools to a death. Simultaneously, the company announced a healthcare AI partnership with CVS Health focused on a real-time consumer engagement platform. The contrasting developments underscore Alphabet's expanding role in high-stakes sectors. The CVS collaboration integrates Gemini into Health100, a platform handling personal interactions across insurers, pharmacies and care providers. Meanwhile, the lawsuit tests whether conversational AI design and crisis protocols carry a duty of care, even outside formal healthcare settings. For investors, the key questions centre on how Alphabet manages legal risk, establishes guardrails and navigates regulatory oversight as its AI tools penetrate sectors requiring heightened safety and compliance standards.

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