Job ID:JP00043935

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 contract workers (via BCforward) 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?

Responsible for managing the selection and utilization of pharmaceuticals and supports core clinical programs such as DUR, DIS and formulary management.

Primary duties may include, but are not limited to:

• Researches and synthesizes detailed clinical data related to pharmaceuticals.
• Prepares and presents therapeutic class reviews and drug monograph information to the Pharmacy and Therapeutics Committee.
• May review and approve or deny coverage for pharmaceuticals (as permitted by state/federal law or state/federal program contracts) based on medical necessity criteria, and coordinates with Anthem or health plan medical directors as needed.
• Serves as a clinical resource to other pharmacists on areas such as prospective, inpatient and retrospective DURs and provides dosage conversion and clinical support for therapeutic interventions.
• Prepares information for network physicians.

Requirements:

• Must possess an active unrestricted license to practice as an RPh required. PharmD preferred.
• 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.
• Must possess an active unrestricted license to practice as an RPh required. PharmD preferred.

Additional Details:

• M-F 8:30 AM to 5:00 PM.
• 100% Remote

BCForward is An Equal Opportunity Employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, or protected veteran status and will not be discriminated against on the basis of disability.

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