Demo

Clinical Pharmacist - Prior Authorization

Elevance Health
Indiana, PA Full Time
POSTED ON 1/8/2025 CLOSED ON 2/6/2025

What are the responsibilities and job description for the Clinical Pharmacist - Prior Authorization position at Elevance Health?

Title : Clinical Pharmacist

Location : Remote position – Must have an active license in Indiana and South Carolina

Candidates must reside within 50 miles or 1-hour commute each way of a relevant pulse point location.

Schedule

Monday-Friday, 8:30am - 5:00pm (rotating weekends)

The Clinical Pharmacist is responsible for managing the selection and utilization of pharmaceuticals and supports core clinical programs such as DUR, DIS and formulary management.

How You Will Make An Impact

Primary duties may include, but are not limited to:

  • Researches and synthesizes detailed clinical data related to pharmaceuticals.
  • Prepares and presents therapeutic class reviews and drug monograph information to the Pharmacy and Therapeutics Committee.
  • May review and approve or deny coverage for pharmaceuticals (as permitted by state/federal law or state/federal program contracts) based on medical necessity criteria, and coordinates with internal stakeholders or health plan medical directors as needed.
  • Serves as a clinical resource to other pharmacists on areas such as prospective, inpatient and retrospective DURs and provides dosage conversion and clinical support for therapeutic interventions.
  • Prepares information for network physicians.

Minimum Requirements

  • Requires BA/BS in Pharmacy.
  • Minimum of 2 years of managed care pharmacy (PBM) experience or residency in lieu of work experience; or any combination of education and experience, which would provide an equivalent background.
  • Requires a registered pharmacist.
  • Must possess an active unrestricted state license to practice pharmacy as a Registered Pharmacist (RPh).
  • For associates working within Puerto Rico who are member or patient facing either in a clinical setting or in the Best Transportation unit, a current PR health certificate and a current PR Law 300 certificate are required for this position.

Preferred Skills, Capabilities And Experiences

PharmD preferred.

For URAC accredited areas, the following professional competencies apply: Associates in this role are expected to have strong oral, written and interpersonal communication skills, problem-solving skills, facilitation skills, and analytical skills.

Please be advised that Elevance Health only accepts resumes for compensation from agencies that have a signed agreement with Elevance Health. Any unsolicited resumes, including those submitted to hiring managers, are deemed to be the property of Elevance Health.

Who We Are

Elevance Health is a health company dedicated to improving lives and communities – and making healthcare simpler. We are a Fortune 25 company with a longstanding history in the healthcare industry, looking for leaders at all levels of the organization who are passionate about making an impact on our members and the communities we serve.

How We Work

At Elevance Health, we are creating a culture that is designed to advance our strategy but will also lead to personal and professional growth for our associates. Our values and behaviors are the root of our culture. They are how we achieve our strategy, power our business outcomes and drive our shared success - for our consumers, our associates, our communities and our business.

We offer a range of market-competitive total rewards that include merit increases, paid holidays, Paid Time Off, and incentive bonus programs (unless covered by a collective bargaining agreement), medical, dental, vision, short and long term disability benefits, 401(k) match, stock purchase plan, life insurance, wellness programs and financial education resources, to name a few.

Elevance Health operates in a Hybrid Workforce Strategy. Unless specified as primarily virtual by the hiring manager, associates are required to work at an Elevance Health location at least once per week, and potentially several times per week. Specific requirements and expectations for time onsite will be discussed as part of the hiring process. Candidates must reside within 50 miles or 1-hour commute each way of a relevant Elevance Health location.

The health of our associates and communities is a top priority for Elevance Health. We require all new candidates in certain patient/member-facing roles to become vaccinated against COVID-19 and Influenza. If you are not vaccinated, your offer will be rescinded unless you provide an acceptable explanation. Elevance Health will also follow all relevant federal, state and local laws.

Elevance Health is an Equal Employment Opportunity employer and all qualified applicants will receive consideration for employment without regard to age, citizenship status, color, creed, disability, ethnicity, genetic information, gender (including gender identity and gender expression), marital status, national origin, race, religion, sex, sexual orientation, veteran status or any other status or condition protected by applicable federal, state, or local laws. Applicants who require accommodation to participate in the job application process may contact elevancehealthjobssupport@elevancehealth.com for assistance.
Pharmacist
Lensa -
Cumberland, MD
Pharmacist
UPMC -
Cumberland, MD
Pharmacist
UPMC - Pittsburgh Medical Center -
Cumberland, MD

If your compensation planning software is too rigid to deploy winning incentive strategies, it’s time to find an adaptable solution. Compensation Planning
Enhance your organization's compensation strategy with salary data sets that HR and team managers can use to pay your staff right. Surveys & Data Sets

What is the career path for a Clinical Pharmacist - Prior Authorization?

Sign up to receive alerts about other jobs on the Clinical Pharmacist - Prior Authorization career path by checking the boxes next to the positions that interest you.
Income Estimation: 
$28,466 - $36,383
Income Estimation: 
$42,166 - $52,471
Income Estimation: 
$39,883 - $51,045
Income Estimation: 
$46,929 - $61,827
Income Estimation: 
$161,728 - $175,646
Income Estimation: 
$159,531 - $186,301
Income Estimation: 
$159,531 - $186,301
Income Estimation: 
$163,938 - $194,389
Income Estimation: 
$176,433 - $208,191
Income Estimation: 
$188,671 - $230,719
Income Estimation: 
$163,938 - $194,389
Income Estimation: 
$176,433 - $208,191
This job has expired.
View Core, Job Family, and Industry Job Skills and Competency Data for more than 15,000 Job Titles Skills Library

Job openings at Elevance Health

Elevance Health
Hired Organization Address Las Vegas, NV Full Time
Process Improvement Analyst - FEP Location : This position will work a hybrid model (remote and office). The ideal candi...
Elevance Health
Hired Organization Address Indianapolis, IN Full Time
Business Information Analyst Sr. Location: This position will work a hybrid model (remote and in office 1 - 2 days per w...
Elevance Health
Hired Organization Address Indianapolis, IN Full Time
Title : Claims Representative I (Health & Dental) - FEP Location : This position will work a hybrid model (remote and of...
Elevance Health
Hired Organization Address Nashville, TN Full Time
Be Part of an Extraordinary Team Carelon Health is a proud member of the Elevance Health family of brands, offering clin...

Not the job you're looking for? Here are some other Clinical Pharmacist - Prior Authorization jobs in the Indiana, PA area that may be a better fit.

Authorization Specialist

Medix, Somerset, PA

AI Assistant is available now!

Feel free to start your new journey!