Hybrid Clinical Pharmacist - Utilization & P&T

Elevance Health; Chicago (IL); Hybrid; USD 119,000 - 215,000; Full time

Job summary

Elevance Health in the United States seeks a Pharmacist Clinical to manage pharmaceutical selection and support clinical utilization management programs, including prior authorization and step therapy. This hybrid role requires 1-2 days in-office and offers collaboration with medical directors, nurses, and account teams while ensuring compliant drug-therapy decisions across the pharmacy benefit.

Active RPh license required; PharmD preferred.

Qualifications

• Requires BA/BS in Pharmacy and an active pharmacist license.
• Minimum of 2 years of managed care PBM experience or residency in lieu of work experience.
• PharmD preferred; residency with Pharmacy and Therapeutics (P&T) 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 DURs and provides dosage conversion and clinical support.
• Leads development and maintenance of clinical criteria for drugs processed on the pharmacy/medical benefits.
• Researches and synthesizes high-quality clinical evidence on drug efficacy and safety.
• Reviews evidence and guidelines to maintain clinical criteria for POS edits (prior authorization, step therapy, quantity limits).
• Presents and collaborates with internal stakeholders (medical directors, nurses, business area leads).
• Provides drug information support to internal stakeholders as needed.

Skills

PBM experience

Clinical pharmacy

DUR knowledge

Cross-functional collaboration

Education

BA/BS in Pharmacy

Active pharmacist license

Residency in Pharmacotherapy (preferred)

Job description

Elevance Health in the United States seeks a Pharmacist Clinical to manage pharmaceutical selection and support clinical utilization management programs, including prior authorization and step therapy. This hybrid role requires 1-2 days in-office and offers collaboration with medical directors, nurses, and account teams while ensuring compliant drug-therapy decisions across the pharmacy benefit.

Active RPh license required; PharmD preferred.