Clinical Pharmacist - Utilization & P&T Specialist (Hybrid)

Elevance Health; Norfolk (VA); Hybrid; USD 119,000 - 215,000; Full time

Job summary

Elevance Health is seeking a Pharmacist Clinical to lead and support clinical utilization management programs, including prior authorization, step therapy and dosing guidance. This hybrid role requires in-office presence 1-2 days per week with flexible options for candidates within commuting distance, and alternate locations considered.

The successful candidate will synthesize clinical data, present drug monographs to the Pharmacy and Therapeutics Committee, and collaborate with medical

Qualifications

• Requires BA/BS in Pharmacy.
• Must possess an active state Pharmacist license.
• Minimum 2 years of managed care pharmacy (PBM) experience or residency in lieu of work experience.

Responsibilities

• Manage selection and utilization of pharmaceuticals and support core clinical utilization management programs (prior authorization, step therapy, quantity limitations).
• Lead development and maintenance of clinical criteria for drugs that process on the pharmacy and medical benefits.
• Provide drug information support to internal stakeholders and pharmacy account management teams.
• Ensure compliance of pharmacy utilization management edits with state/federal mandates and contractual agreements.

Skills

Clinical pharmacy

PBM experience

Regulatory knowledge

Education

BA/BS in Pharmacy

Active Pharmacist license

Residency in lieu of work experience

Job description

Elevance Health is seeking a Pharmacist Clinical to lead and support clinical utilization management programs, including prior authorization, step therapy and dosing guidance. This hybrid role requires in-office presence 1-2 days per week with flexible options for candidates within commuting distance, and alternate locations considered.

The successful candidate will synthesize clinical data, present drug monographs to the Pharmacy and Therapeutics Committee, and collaborate with medical