Remote Prior Authorization Pharmacist | DUR & P&T Support

Elevance Health; North Carolina; Hybrid; USD 110,000 - 140,000; Full time

Job summary

Elevance Health is seeking a Prior Authorization Clinical Pharmacist to evaluate and manage pharmaceutical use, supporting DUR, DIS, and formulary management. The role involves presenting drug information to the Pharmacy and Therapeutics Committee and collaborating with network physicians.

The position supports a hybrid/virtual work arrangement with in-person training and requires an active pharmacist license.

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.
• Current unrestricted Pharmacist license in applicable state(s) required.
• For Puerto Rico associates, PR health certificate and PR Law 300 certificate required.

Responsibilities

• Evaluate and manage the selection and utilization of pharmaceuticals for safety, efficacy and cost-effectiveness.
• Support Drug Utilization Review (DUR), Drug Information Services (DIS), and formulary management.
• Review and approve/deny coverage for pharmaceuticals based on medical necessity criteria.
• Provide clinical guidance on interventions, dosage conversions, and evidence-based medication use.
• Prepare and present drug information to network physicians and the Pharmacy and Therapeutics Committee.

Skills

Prior Authorization

PBM experience

Pharmacist license

Clinical pharmacy

Education

BA/BS in Pharmacy

Pharmacist license

Job description

Elevance Health is seeking a Prior Authorization Clinical Pharmacist to evaluate and manage pharmaceutical use, supporting DUR, DIS, and formulary management. The role involves presenting drug information to the Pharmacy and Therapeutics Committee and collaborating with network physicians.

The position supports a hybrid/virtual work arrangement with in-person training and requires an active pharmacist license.