Pharmacist Clinical- Provider Support
Elevance Health

Job Info

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Pharmacist Clinical

Location: Virtual with 1-3 days/week in the field meeting with providers around Florida.

A proud member of the Elevance Health family of companies, CarelonRx (formerly IngenioRx) leverages the power of new technologies and a strong, clinical-first lens, to deliver member-centered, lasting pharmacy care.

The Pharmacist Clinical is responsible for providing clinical pharmacy support to Medicare, Commercial, and Medicaid providers. Duties and responsibilities will be focused on improving quality (STAR and HEDIS) and cost measures through close collaboration with providers engaged in value-based care arrangements. You will be responsible for influencing providers to change prescribing practices to improve members' health and reduce the total cost of care.

How you will make an impact:

• Responsible for suggesting best practices to support core clinical programs such as formulary management.
• Researches and synthesizes detailed clinical data related to pharmaceuticals to assist contracted physician prescribers in achieving formulary and quality goals.
• Serves as a clinical resource to external prescribing providers and pharmacists on areas such as prospective, inpatient and retrospective DURs and provides dosage conversion and clinical support for therapeutic interventions.
• Prepares information for network physicians utilizing data within provider tools utilizing Excel, Tableau, etc.
• Support network physicians by analyzing organizational and practice-level reports and identifying opportunities to improve pharmacy quality (STAR, HEDIS, etc.) and reduce pharmacy cost.
• During practice-level discussions, act as a subject matter expert in pharmacy-related clinical measures for value-based care agreements- Clinical, Cost, etc.
• Attend external provider meetings to communicate practice-level pharmacy goals and opportunities for reaching goals.
• Educate internal matrix provider partners about pharmacy programs and goals.
• Field questions from providers related to Pharmacy programs (benefits, reporting tools, CMS, formulary, etc.).
• Participate in development and testing of pharmacy provider tools with the lens of a clinical user.
• Close feedback loop between Pharmacy and Providers.
• Stay up to date with STAR & HEDIS measures.
• Provider education to the external network providers as requested/needed in support of Clinical pharmacy measures.

Minimum 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).

Preferred Skills, Capabilities, and Experiences:

• PharmD preferred.
• Experience with Medicaid programs, particularly in Florida preferred.
• Microsoft Excel experience strongly preferred.
• PBM or managed care experience strongly preferred.
• Passionate about building relationships with external provider partners to improve member health preferred.

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.

Please be advised that Elevance Health only accepts resumes for compensation from agencies that have a signed agreement with Elevance Health. Any unsolicited resumes, including those submitted to hiring managers, are deemed to be the property of Elevance Health.

Who We Are

Elevance Health is a health company dedicated to improving lives and communities - and making healthcare simpler. We are a Fortune 25 company with a longstanding history in the healthcare industry, looking for leaders at all levels of the organization who are passionate about making an impact on our members and the communities we serve.

How We Work

At Elevance Health, we are creating a culture that is designed to advance our strategy but will also lead to personal and professional growth for our associates. Our values and behaviors are the root of our culture. They are how we achieve our strategy, power our business outcomes and drive our shared success - for our consumers, our associates, our communities and our business.

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.

Elevance Health operates in a Hybrid Workforce Strategy. Unless specified as primarily virtual by the hiring manager, associates are required to work at an Elevance Health location at least once per week, and potentially several times per week. Specific requirements and expectations for time onsite will be discussed as part of the hiring process. Candidates must reside within 50 miles or 1-hour commute each way of a relevant Elevance Health location.

The health of our associates and communities is a top priority for Elevance Health. We require all new candidates in certain patient/member-facing roles to become vaccinated against COVID-19. If you are not vaccinated, your offer will be rescinded unless you provide an acceptable explanation. Elevance Health will also follow all relevant federal, state and local laws.

Elevance Health is an Equal Employment Opportunity employer and all qualified applicants will receive consideration for employment without regard to age, citizenship status, color, creed, disability, ethnicity, genetic information, gender (including gender identity and gender expression), marital status, national origin, race, religion, sex, sexual orientation, veteran status or any other status or condition protected by applicable federal, state, or local laws. Applicants who require accommodation to participate in the job application process may contact elevancehealthjobssupport@elevancehealth.com for assistance.

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