Population Health Management Pharmacist - CarelonRx
Elevance Health•Indianapolis, IN
•Hybrid
About The Position
The Population Health Management Pharmacist (Clinical Pharmacist) oversees clinical program quality and appropriate medication use for in-scope provider groups to support quality and cost goals.
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).
Nice To Haves
- PharmD preferred.
- Experience in medication use quality improvement programs, analyzing pharmacy spend and trends, and Medicare Star Part D measures strongly desired.
- Experience working with Medicare and Commercial providers strongly preferred.
- PBM or Managed Care experience highly desired.
- Proficiency with Excel preferred.
Responsibilities
- Researches and synthesizes detailed clinical data related to pharmaceuticals to assist contracted providers in achieving cost and quality goals.
- Serves as a clinical resource to other pharmacists and contracted providers in areas such as prospective, inpatient, and retrospective DURs and clinical support for therapeutic interventions.
- Prepares information for network physicians using data within provider tools including Excel.
- Evaluate pharmacy quality program data and work with stakeholders to identify, prioritize, and implement strategies to optimize medication use and manage pharmacy spending effectively.
- During practice-level discussions, act as a subject matter expert in pharmacy-related clinical measures for value-based care agreements.
- Work to improve pharmacy quality by staying up to date on STAR and HEDIS measures.
- Provider education to support clinical pharmacy measures and reduce pharmacy costs.
- Build impactful relationships with providers to close the feedback loop between pharmacy and provider.
- Act as a pharmacy SME to internal and leadership teams.
Benefits
- merit increases
- paid holidays
- Paid Time Off
- incentive bonus programs
- medical
- dental
- vision
- short and long term disability benefits
- 401(k) +match
- stock purchase plan
- life insurance
- wellness programs
- financial education resources
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What This Job Offers
Job Type
Full-time
Career Level
Mid Level
