Clinical Pharmacist - CarelonRx

Elevance Health • Maryland, OH

11d • Hybrid

About The Position

CarelonRx is a proud member of the Elevance Health family of companies providing unparalleled level of service in pharmacy benefits. By leveraging the power of new technologies, our strong, clinical-first lens and deep pharmacy expertise, we are actively defining our innovative role in the industry.

Build the Possibilities. Make an Extraordinary Impact.

Title: Clinical Pharmacist

Location(s): Indianapolis, IN, Mason, OH, Iselin, NJ, Mendota Heights, MN, Hanover, MD

Hybrid: This role requires associates to be in-office 1 - 2 days per week, fostering collaboration and connectivity, while providing flexibility to support productivity and work-life balance. This approach combines structured office engagement with the autonomy of virtual work, promoting a dynamic and adaptable workplace. Alternate locations may be considered. Please note that per our policy on hybrid/virtual work, candidates not within a reasonable commuting distance from the posting location(s) will not be considered for employment, unless an accommodation is granted as required by law.

The Clinical Pharmacist is responsible for managing and developing clinical pharmacy programs to support quality, safety and industry standards. Serves as a clinical resource to other pharmacists in areas such as retrospective DURs and medication management and provides clinical support for pharmacy interventions.

Requirements

• Requires BA/BS in Pharmacy.
• Minimum of 2 years of managed care pharmacy (PBM) experience or residency in lieu of work experience; or any combination of education and experience, which would provide an equivalent background.
• Requires a registered pharmacist.
• Must possess an active unrestricted state license to practice pharmacy as a Registered Pharmacist (RPh) in the state of Indiana.
• For associates working within Puerto Rico who are member or patient facing either in a clinical setting or in the Best Transportation unit, a current PR health certificate and a current PR Law 300 certificate are required for this position.
• Unless expressly allowed by state or federal law, or regulation, must be located in a state or territory of the United States when conducting utilization review or an appeals consideration and cannot be located on a US military base, vessel or any embassy located in or outside of the US, unless they are command-sanctioned activities.
• For URAC accredited areas, the following professional competencies apply: Associates in this role are expected to have strong oral, written and interpersonal communication skills, problem-solving skills, facilitation skills, and analytical skills.

Nice To Haves

• PharmD preferred.
• Knowledge of NCQA, HEDIS and Stars measures is preferred.
• Excellent communication and project management skills preferred.
• Ability to work collaboratively across departments and with external partners preferred.

Responsibilities

• Researches and synthesizes detailed clinical data related to pharmaceuticals.
• Prepares and presents therapeutic class reviews and drug monograph information to the Pharmacy and Therapeutics Committee.
• Serves as a clinical resource to other pharmacists on areas such as prospective, inpatient and retrospective DURs and provides dosage conversion and clinical support for therapeutic interventions.
• Create and implement pharmacy quality programs to promote healthy outcomes among members.
• Partner with health plans to fulfill clinical program mandates, reporting requirements, and quality measure support.
• Support business growth by drafting clinical program summaries and outcomes for Requests for Proposals (RFP)

Benefits

• We offer a range of market-competitive total rewards that include merit increases, paid holidays, Paid Time Off, and incentive bonus programs (unless covered by a collective bargaining agreement), medical, dental, vision, short and long term disability benefits, 401(k) +match, stock purchase plan, life insurance, wellness programs and financial education resources, to name a few.

What This Job Offers

• Job Type: Full-time
• Career Level: Mid Level
• Number of Employees: 5,001-10,000 employees