Remote Clinical Pharmacist - Prior Authorization

The Elevance Health Companies, Inc.; Lowes Grove (NC); Híbrido; USD 110.000 - 150.000; Jornada completa

Ventajas ofrecidas por este puesto de trabajo

Virtual eligibility

Descripción de la vacante

Elevance Health is seeking a Clinical Pharmacist (Prior Authorization) to support pharmaceutical utilization and formulary management. The role requires North Carolina or Kansas licensure, with virtual eligibility and periodic in-person training at office locations.

Responsibilities include synthesizing clinical data, presenting drug monographs to the Pharmacy and Therapeutics Committee, and coordinating coverage decisions with health plan stakeholders.

Formación

• Requires BA/BS in Pharmacy.
• Minimum of 2 years of managed care pharmacy (PBM) experience or residency in lieu of work experience.
• Requires a registered pharmacist.
• Active unrestricted state license to practice pharmacy as a Registered Pharmacist (RPh).
• For Puerto Rico associates, PR health certificate and PR Law 300 certificate are required.

Responsabilidades

• Manages selection and utilization of pharmaceuticals.
• Supports core clinical programs such as DUR, DIS and formulary management.
• Reviews and may approve or deny coverage for pharmaceuticals based on medical necessity criteria.
• Coordinates with internal stakeholders or health plan medical directors as needed.
• Serves as a clinical resource to pharmacists on DURs and provides dosage conversion and clinical support.

Conocimientos

Pharmacist license

Clinical pharmacology

Communication skills

Educación

BA/BS in Pharmacy

PharmD (preferred)

Descripción del empleo

Elevance Health is seeking a Clinical Pharmacist (Prior Authorization) to support pharmaceutical utilization and formulary management. The role requires North Carolina or Kansas licensure, with virtual eligibility and periodic in-person training at office locations.

Responsibilities include synthesizing clinical data, presenting drug monographs to the Pharmacy and Therapeutics Committee, and coordinating coverage decisions with health plan stakeholders.