Mgr Pharmacy Clinical Ops
Location: Hybrid 0-3 times/month if located within 50 miles of a PulsePoint Office
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.
Responsible for developing and implementing clinical pharmacy programs to promote quality and cost-effective drug utilization for the Provider Collaboration team.
How you will make an impact:
- Assists in the development of new clinical programs and reporting for the Provider Collaboration team.
- Manages clinical pharmacy provider team and ensure clients' (internal provider support teams & external prescriber teams) objectives and deliverables are met.
- Oversees departmental processes, policies and procedures, training, and communication.
- Reports and analyzes program trends.
- 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 managed care, authorization, or related pharmacy experience; or any combination of education and experience, which would provide an equivalent background.
- 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.
Preferred Skills, Capabilities, and Experiences:
- PharmD preferred.
- Recent Population Health Management prescriber experience, including value-based care contracting.
- Experience in quality measures (HEDIS/Star)
- Experience operating in a matrixed environment to gain alignment and move projects forward.
- Experience establishing and maintaining value-based care programs with prescribers or leading a team of individuals who establish and maintain value-based programs with prescribers.
- Working knowledge of Microsoft applications include Excel.
- This role will be responsible for managing a high performing team of pharmacists, identifying areas of improvement and exploring innovative ways to partner with our value-based care providers.
- The manager will be responsible for providing oversight to pharmacists located in ambulatory clinics and pharmacists (member level interventions) working virtually with providers.
- The manager will be responsible for coordinating team needs within the Provider Collaboration team including development of new programs, analytics needs, training, etc.
- You'll thrive in this role if you: like a fast-paced environment where your contributions are recognized, enjoy collaborating with people through virtual meetings and enjoy creating solutions to complex problems.
For candidates working in person or remotely in the below locations, the salary* range for this specific position is $115,520 to $207,936.
Locations: California; Colorado; Nevada; Washington State; Jersey City, NJ; New York City, NY; Ithaca, NY and Westchester County, NY
In addition to your salary, Elevance Health offers benefits such as, a comprehensive benefits package, incentive and recognition programs, equity stock purchase and 401k contribution (all benefits are subject to eligibility requirements). The salary offered for this specific position is based on a number of legitimate, non-discriminatory factors set by the company. The company is fully committed to ensuring equal pay opportunities for equal work regardless of gender, race, or any other category protected by federal, state, and local pay equity laws .
* The salary range is the range Elevance Health in good faith believes is the range of possible compensation for this role at the time of this posting. This range may be modified in the future and actual compensation may vary from posting based on geographic location, work experience, education and/or skill level. Even within the range, the actual compensation will vary depending on the above factors as well as market/business considerations. No amount is considered to be wages or compensation until such amount is earned, vested, and determinable under the terms and conditions of the applicable policies and plans. The amount and availability of any bonus, commission, benefits, or any other form of compensation and benefits that are allocable to a particular employee remains in the Company's sole discretion unless and until paid and may be modified at the Company’s sole discretion, consistent with the law.
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. A Fortune 20 company with a longstanding history in the healthcare industry, 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 in certain patient/member-facing roles 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 2022, has been ranked for five years running as one of the 2023 World’s Most Admired Companies by Fortune magazine, and is a growing Top 20 Fortune 500 Company. To learn more about our company and apply, please visit us at careers.ElevanceHealth.com. 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 firstname.lastname@example.org for assistance.