Location: This position will work a hybrid model (1-2 days/week in office). The ideal candidate will live within 50 miles of the posted Elevance Health PulsePoint locations.
A proud member of the Elevance Health family of companies, CarelonRx (formerly IngenioRx) leverages the power of new technologies and a strong, clinical-first lens, to deliver member-centered, lasting pharmacy care.
The Pharmacist Clinical Configuration 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:
Researches and synthesizes detailed clinical data related to pharmaceuticals.
Assists in developing and configuring prior authorization decision trees in the workflow tool.
Participates in quality assurance of prior authorization decision trees within the workflow tool.
Provides clinical consulting services to internal partners.
Assists in implementing clinical programs within the prior authorization space.
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).
Preferred Skills, Capabilities, and Experiences:
PharmD preferred.
Prior authorization experience preferred.
Exposure to policy through P&T committee and prior authorizations 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.
