Be Part of an Extraordinary Team

CarelonRx is a proud member of the Elevance Health family of companies providing unparalleled level of service in pharmacy benefits. By leveraging the power of new technologies, our strong, clinical-first lens and deep pharmacy expertise, we are actively defining our innovative role in the industry.

Build the Possibilities. Make an Extraordinary Impact.

Title: Clinical Pharmacist Senior

Location(s): Durham, NC, Winston-Salem, NC

Hybrid: This role requires associates to be in-office 1 - 2 days per week, fostering collaboration and connectivity, while providing flexibility to support productivity and work-life balance. This approach combines structured office engagement with the autonomy of virtual work, promoting a dynamic and adaptable workplace.

Please note that per our policy on hybrid/virtual work, candidates not within a reasonable commuting distance from the posting location(s) will not be considered for employment, unless an accommodation is granted as required by law.

The NC Medicaid Health Plan is looking for a dedicated Clinical Pharmacist Senior to support the Children and Families Specialty Program (CFSP). This pharmacist will act as the primary contact for managing communications with stakeholders associated with the CFSP, and will ensure effective responses and solutions to any issues related to the pharmacy benefit program. Additionally, this role will serve as a vital resource, collaborating with various departments to enhance the quality and performance of the pharmacy benefit for the CFSP and contribute to the overall success of the program.

How you will make an impact: 

• Provides clinical consulting services to clients and implements clinical information and education programs, with a focus on long-acting injectable antipsychotics (LAIAs) and alternative treatments.

• Assists in developing and overseeing medication management programs specific to CFSP members, ensuring alignment with formulary guidelines.

• Performs drug utilization analyses and identifies medication adherence, polypharmacy, and contraindication issues, working collaboratively with pharmacies, providers, and the Care Management (CM) department.

• Liaison with CarelonRx clinical programs and Clinical Pharmacy Care Center (CPCC) resources for CFSP-specific program development or enhancements, if applicable.

• Engages in multi-disciplinary rounds, child and family team meetings, and provider meetings as requested by health plan clinical leadership to support the complex needs of the population.

• Develops reports for the CM department, such as identifying members missing antipsychotic medication refills, and engages in routine data submission to CM and clinical or quality leadership teams.

Minimum Requirements:

• Requires BA/BS in Pharmacy.

• Minimum of 4 years of experience as a pharmacist in a clinical setting; 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 highly preferred

• Experience with behavioral health and psychiatric conditions/medications for children and adults, serving as a resource to the plan clinical leadership team strongly preferred

• Understanding of long-acting injectable antipsychotics (LAIAs) and alternative treatment methods strongly 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.

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.

Qualified applicants with arrest or conviction records will be considered for employment in accordance with all federal, state, and local laws, including, but not limited to, the Los Angeles County Fair Chance Ordinance and the California Fair Chance Act.