Managed Care Pharmacy Resident – Formulary & Care Strategy

The Elevance Health Companies, Inc.; Mason (OH); Hybrid; USD 65,000 - 90,000; Full time

Job summary

Elevance Health is seeking a Managed Care Pharmacy Resident in Ohio to join our team. The role blends in-office collaboration 1–2 days a week with flexible virtual work, and offers exposure to formulary policy and member care strategies.

You will complete therapeutic class reviews, support prior authorizations, and contribute a year-long project aimed at improving medication management for our members. You will participate in committee work and work to optimize formulary utilization while

Qualifications

• PharmD from an accredited school of pharmacy is required.
• Must be registered pharmacist with active license or able to obtain within 90 days of start date.
• Authorized to work in the U.S. without visa sponsorship.

Responsibilities

• Complete work related to the Pharmacy and Therapeutics Committee including therapeutic class reviews, policy review, drug monographs, and formulary recommendations.
• Develop strategies to drive formulary utilization and optimization.
• Complete a year-long project targeted at improving member care through proper medication management.
• Perform weekly clinical prior authorizations and coverage determinations for Medicaid and Medicare.
• Participate in the pharmaceutical care management process through reviewing member profiles, recommending members for lock-in, case management or disease management.
• Respond to and resolve issues related to member/provider complaints, claims processing issues and appeals.

Skills

Pharmacist license

PharmD

Communication

Public speaking

Problem solving

Organizational skills

Managed care

Office software

Education

PharmD degree

Tools

Microsoft Office

Job description

Elevance Health is seeking a Managed Care Pharmacy Resident in Ohio to join our team. The role blends in-office collaboration 1–2 days a week with flexible virtual work, and offers exposure to formulary policy and member care strategies.

You will complete therapeutic class reviews, support prior authorizations, and contribute a year-long project aimed at improving medication management for our members. You will participate in committee work and work to optimize formulary utilization while