Remote Clinical Pharmacist — Prior Authorization

Elevance Health; Lowes Grove (NC); Hybrid; USD 120,000 - 150,000; Full time

Job summary

Elevance Health is seeking a Pharmacist Clinical with active license in North Carolina or Kansas. This virtual-eligible role allows remote work with required in-person training and occasional onsite days within a reasonable distance of Elevance Health offices.

The Clinical Pharmacist (Prior Authorization) will manage pharmaceutical selection, support DUR, DIS and formulary programs, and review coverage based on medical necessity, collaborating with health plan medical directors as needed.

Qualifications

• Requires BA/BS in Pharmacy.
• Minimum of 2 years of managed care pharmacy experience or residency.
• Requires a registered pharmacist and active state license to practice.
• For Puerto Rico associates, PR health certificate and PR Law 300 certificate required.
• Licensure in Kansas or North Carolina preferred.

Responsibilities

• Researches and synthesizes detailed clinical data related to pharmaceuticals.
• Prepares and presents therapeutic class reviews and drug monographs to the Pharmacy and Therapeutics Committee.
• May review and approve or deny coverage for pharmaceuticals based on medical necessity criteria.
• Serves as a clinical resource to other pharmacists on prospective, inpatient and retrospective DURs and provides dosage conversion.
• Prepares information for network physicians.

Skills

Communication skills

Problem solving

Analytical skills

Interpersonal skills

Pharmaceutical care

Education

BA/BS in Pharmacy

PharmD preferred

Job description

Elevance Health is seeking a Pharmacist Clinical with active license in North Carolina or Kansas. This virtual-eligible role allows remote work with required in-person training and occasional onsite days within a reasonable distance of Elevance Health offices.

The Clinical Pharmacist (Prior Authorization) will manage pharmaceutical selection, support DUR, DIS and formulary programs, and review coverage based on medical necessity, collaborating with health plan medical directors as needed.