Pharmacy Population Health Specialist (Hybrid)

Elevance Health; Kentucky; Hybrid; USD 50,000 - 65,000; Full time

Job summary

Elevance Health is seeking a Pharmacy Support Coordinator to interpret and review moderately complex prescriptions and population health data. The role collaborates with providers to optimize formulary decisions and resolve adjudication issues, while supporting performance improvements within provider networks.

Hybrid role with in-office days to foster collaboration. Requires pharmacy license, HS diploma and 2+ years of pharmacy experience; URAC/Medicare knowledge is a plus.

Qualifications

• Strong oral, written and interpersonal communication skills
• Problem-solving abilities and analytical mindset
• Ability to facilitate and collaborate across teams

Responsibilities

• Verifies member information and health data to identify opportunities to improve care
• Educates providers on pharmacy rules and resources
• Processes data requests and ensures Medicare & Commercial compliance
• Conducts provider outreach to close quality gaps in care
• Responds to inquiries from physicians, sales and internal partners
• Generates reports on physician utilization and clinical criteria
• Maintains records of presentations and monthly reports
• Supports overall performance improvement within provider organizations

Skills

Communication

Problem solving

Interpersonal skills

Analytical skills

Education

High school diploma or equivalent

Job description

Elevance Health is seeking a Pharmacy Support Coordinator to interpret and review moderately complex prescriptions and population health data. The role collaborates with providers to optimize formulary decisions and resolve adjudication issues, while supporting performance improvements within provider networks.

Hybrid role with in-office days to foster collaboration. Requires pharmacy license, HS diploma and 2+ years of pharmacy experience; URAC/Medicare knowledge is a plus.