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Manager Pharmacy Clinical Operations


  • OH, Mason
  • FL, Miami
  • TX, Grand Prairie



Hybrid Role, some in office requirement. Preferred Locations: OH, FL, TX

Carelon Rx's Advanced Home Delivery Pharmacy Org is looking to hire a MGR Pharmacy Clinical Ops.  This People Leader will be responsible for leading business operations through coaching and development of direct report pharmacy leaders who support pharmacy call center job functions that include patient outreach, prescriber outreach, clinical services and digital encounters in a manner that maximizes the patient experience, clinical outcomes and delivers on business expectations. S/He will be responsible for operational leadership associated with our front end pharmacy services, developing and implementing clinical pharmacy programs to promote quality outcomes and cost-effective drug utilization and provide additional support deemed necessary by the business.

Primary duties may include, but are not limited to:

  • Overseeing pharmacists and or pharmacists leads supporting operational and clinical pharmacy call center services (such as patient outreach, provider outreach, data verification, late to refill and therapeutic interchange) and assists in the development of new clinical products or enhancement of pharmacy platforms
  • Manages clinical pharmacy operations and staff to ensure patient and provider objectives and deliverables are met
  • Oversees departmental processes, policies and procedures, training, quality management and all related communications
  • Reports and analyzes pharmacy program trend through utilization of reporting tools and metrics (KPI’s) to monitor staff productivity, deliverables, timelines, and quality of work and partner with supporting resources to adjust staffing levels and processes as needed to ensure operational effectiveness
  • Ensures achievement of department goals and objectives.
  • Hires, trains, coaches, counsels, and evaluates performance of direct reports.

Requires at least a BA/BS in Pharmacy or a PharmD and minimum of 5 years of experience in central fill or mail order pharmacy operations, managed care, prior authorization , or related pharmacy experience; or any combination of education and experience, which would provide an equivalent background.

Preferred Experiences:

  • Bilingual, Spanish
  • Holds unrestricted RPh state licensure in at least 1-2 states with willingness to obtain additional licenses as needed

Must possess an active unrestricted state license or certification to practice pharmacy within the scope of practice in a state or territory of the United States (Rph).  Unless expressly allowed by state or federal law, or regulation, must be located in a state or territory of the United States when conducting utilization review or an appeals consideration and cannot be located on a US military base, vessel or any embassy located in or outside of the United States. 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 from agencies that have a signed agreement with Elevance Health. Accordingly, Elevance Health is not obligated to pay referral fees to any agency that is not a party to an agreement with Elevance Health. Thus, any unsolicited resumes, including those submitted to hiring managers, are deemed to be the property of Elevance Health.

Be part of an Extraordinary Team

Elevance Health is a health company dedicated to improving lives and communities – and making healthcare simpler. Previously known as Anthem, Inc., we have evolved into a company focused on whole health and updated our name to better reflect the direction the company is heading.

We are looking for leaders at all levels of the organization who are passionate about making an impact on our members and the communities we serve. You will thrive in a complex and collaborative environment where you take action and ownership to solve problems and lead change. Do you want to be part of a larger purpose and an evolving, high-performance culture that empowers you to make an impact?

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.

The health of our associates and communities is a top priority for Elevance Health. We require all new candidates to become vaccinated against COVID-19. If you are not vaccinated, your offer will be rescinded unless you provide – and Elevance Health approves – a valid religious or medical explanation as to why you are not able to get vaccinated that Elevance Health is able to reasonably accommodate. Elevance Health will also follow all relevant federal, state and local laws.

Elevance Health has been named as a Fortune Great Place To Work in 2021, is ranked as one of the 2021 World’s Most Admired Companies among health insurers by Fortune magazine, and a Top 20 Fortune 500 Companies on Diversity and Inclusion. To learn more about our company and apply, please visit us at 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 for assistance.

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