Pharmacy Support & Population Health Specialist (Hybrid)

Elevance Health; Mason (OH); Hybrid; USD 42,000 - 54,000; Full time

Job summary

Elevance Health is seeking a Pharmacy Support Coordinator to interpret moderately complex prescriptions, review population health data, and troubleshoot adjudication issues with provider engagement. This hybrid role requires 1–2 days in-office weekly and supports collaboration across care teams.

Responsibilities include physician data validation, education on formulary rules, and generating utilization reports.

Qualifications

• Requires an active, professional license (state Pharmacy Technician Certification or National Certification) to practice as a Pharmacy Technician.
• HS diploma or equivalent and minimum of 2 years of pharmacy experience; or equivalent combination of education and experience.

Responsibilities

• Verifies member information, clinical and cost of care data to identify opportunities to improve health.
• Educates providers on pharmacy-based rules related to prescriptions and medication resources or assistance programs.
• Processes data requests from physicians' offices and ensures compliance with Medicare & Commercial requirements.
• Conducts outreach to provider offices to close critical quality gaps in care.
• Provides resolution to grievances from provider groups.
• Responds to inquiries from physicians, sales team, and internal partners related to formulary and prescription benefits.
• Generates reports relating to physician utilization, Clinical Criteria, and other ad hoc reports.
• Maintains record keeping of presentations and monthly reports.
• Supports the improvement of overall performance within provider organizations.

Education

HS diploma or equivalent

Pharmacy Technician Certification

Job description

Elevance Health is seeking a Pharmacy Support Coordinator to interpret moderately complex prescriptions, review population health data, and troubleshoot adjudication issues with provider engagement. This hybrid role requires 1–2 days in-office weekly and supports collaboration across care teams.

Responsibilities include physician data validation, education on formulary rules, and generating utilization reports.