Population Health Management Pharmacist - CarelonRx

Population Health Management Pharmacist (Clinical Pharmacist)
Primary Location(s):
Indianapolis, IN
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 Population Health Management Pharmacist (Clinical Pharmacist) oversees clinical program quality and appropriate medication use for in-scope provider groups to support quality and cost goals.

• Researches and synthesizes detailed clinical data related to pharmaceuticals to assist contracted providers in achieving cost and quality goals.

• Serves as a clinical resource to other pharmacists and contracted providers in areas such as prospective, inpatient, and retrospective DURs and clinical support for therapeutic interventions.

• Prepares information for network physicians using data within provider tools including Excel.

• Evaluate pharmacy quality program data and work with stakeholders to identify, prioritize, and implement strategies to optimize medication use and manage pharmacy spending effectively.

• During practice-level discussions, act as a subject matter expert in pharmacy-related clinical measures for value-based care agreements.

• Work to improve pharmacy quality by staying up to date on STAR and HEDIS measures.

• Provider education to support clinical pharmacy measures and reduce pharmacy costs.

• Build impactful relationships with providers to close the feedback loop between pharmacy and provider.

• Act as a pharmacy SME to internal and leadership teams

• 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).

• PharmD preferred.

• Experience in medication use quality improvement programs, analyzing pharmacy spend and trends, and Medicare Star Part D measures strongly desired.

• Experience working with Medicare and Commercial providers strongly preferred.

• PBM or Managed Care experience highly desired.

• Proficiency with Excel preferred.

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.

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.

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…