Remote Prior Authorization Pharmacist

Elevance Health; Durham (NC); Remote; USD 119,000 - 206,000; Full time

Benefits offered by this job

Comprehensive benefits package

Equity stock purchase plan

401(k) contribution

Job summary

Elevance Health is seeking a Prior Authorization Clinical Pharmacist to evaluate and manage pharmaceutical use, supporting Drug Utilization Review (DUR), Drug Information Services (DIS), and formulary management.

This full-time, virtual role requires a BA/BS in Pharmacy, a pharmacy license, and PBM experience. Preference for NC licensure and PharmD. In-person training sessions are required.

Qualifications

• 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 and current unrestricted license in applicable state(s).
• For associates in PR/ Puerto Rico, PR health certificate and PR Law 300 certificate may be required.
• Strong oral, written and interpersonal communication skills; analytical abilities are essential.

Responsibilities

• Researches and synthesizes detailed clinical data related to pharmaceuticals.
• Prepares therapeutic class reviews and drug monographs for 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 DURs and provides dosage conversions and clinical support.
• Develops and communicates drug information and recommendations to network physicians and clinical teams.

Skills

Oral communication

Written communication

Interpersonal skills

Analytical skills

Clinical data analysis

Education

BA/BS in Pharmacy

PharmD

Job description

Elevance Health is seeking a Prior Authorization Clinical Pharmacist to evaluate and manage pharmaceutical use, supporting Drug Utilization Review (DUR), Drug Information Services (DIS), and formulary management.

This full-time, virtual role requires a BA/BS in Pharmacy, a pharmacy license, and PBM experience. Preference for NC licensure and PharmD. In-person training sessions are required.