Pharmacist Clinical Configuration

Location:
  • OH-MASON, 4361 IRWIN SIMPSON RD, United States of America
  • Georgia - Atlanta
  • Indiana - Indianapolis
  • Missouri - St. Louis
  • New Hampshire - Manchester
  • North Carolina - Durham
  • North Carolina - Winston-Salem
  • Ohio - Cincinnati
  • Ohio - Columbus
  • Ohio - Seven Hills
  • Texas - Grand Prairie
  • Virginia - Richmond
Job Reference:
JR144581
Date Posted:
03/12/2025
Anticipated Date Close:
03/19/2025

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: Pharmacist Clinical Configuration

Location(s):

  • 4361 Irwin Simpson Road, Mason, OH

  • 8940 Lyra Dr., STE 300, Columbus, OH

  • 3075 Vandercar Way, Cincinnati, OH

  • 6000 Lombardo Center, STE 200, Seven Hills, OH

  • 5650 University PKWY, Winston Salem, NC

  • 1960 Ivy Creek BLVD, Durham, NC

  • 2505 N HWY 360, STE 300, Grand Prairie, TX

  • 740 W. Peachtree St. NW, Atlanta, GA

  • 220 Virginia Ave, Indianapolis, IN

  • 1831 Chestnut St., St. Louis, MO

  • 1155 Elm St., STE 100 & 200, Manchester, NH

  • 2103 Staples Mill Rd., Richmond, VA

Schedule: This position will take part in Elevance Health's hybrid work model which includes remote work and in-office collaboration. The hybrid schedule for this position is one day per week in office. Candidates must reside within 50 miles or 1-hour commute each way of the location listed above.

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: 

Primary duties may include, but are not limited to:  

  • 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.

 

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.

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.