Pharmacist Clinical

Clinical Analytic Pharmacist

A proud member of the Elevance Health family of companies,
Carelon Rx (formerly Ingenio Rx) leverages the power of new technologies and a strong, clinical-first lens, to deliver member-centered, lasting pharmacy care.

The selected candidate must reside within 50 miles of a PulsePoint office. Preferably Mason, OH;
St. Louis, MO;
Durham, NC;
Grand Prairie, TX;
Chicago, IL;
Indianapolis, IN;
Nashville, TN. Alternate locations may be considered if candidates reside within a commuting distance from an office.

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 Pharmacist Clinical is responsible for managing the selection and utilization of pharmaceuticals and supports core clinical programs such as DUR, DIS, and formulary management. Primary responsibility is planning and development of budget impact models for pipeline drugs, biologics, and gene therapies using medical and pharmacy claims data. This role requires close collaboration with cross‑functional partners—including Clinical Pharmacy, Formulary, Actuary, Pricing/Underwriting, and other key business leaders.

• Research, synthesize, and evaluate clinical evidence related to the efficacy, safety, and attributes of drugs, biologics, and gene therapies.
• Drug, biologic, and gene therapy pipeline monitoring and evaluation support.
• Prepares and presents therapeutic class reviews and drug monograph information to the Pharmacy and Therapeutics Committee.
• 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.
• Evaluate third party sources for drug pipeline financial forecasts.
• Estimate future financial impact of new therapeutic options leveraging clinical and analytic data for Commercial, Medicare, and Medicaid lines of business.
• Refine model estimates based on real‑time utilization patterns and post‑marketing information.

• 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).

• Advance degree preferred (Pharm
  
  D, MBA, MPH, or equivalent)
• 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 US, unless they are command‑sanctioned activities.
• Minimum of 2 years of experience in pharmacy benefit management (PBM).
• Strong understanding of analytics, statistics, or epidemiology.
• Strong analytical, data interpretation, and trend management skills.
• Experience in analysis of large pharmacy and medical data with knowledge and skilled in MS Excel and SQL is highly preferred. Additional statistical or analytic tools skills are a plus (e.g. SAS, Python, Databricks, and/or Snowflake).
• Excellent communication and presentation skills, with the ability to engage leadership and cross‑functional stakeholders.
• Proven project management skills, including timeline development, prioritization, and cross‑functional coordination.

For URAC accredited areas, the following professional competencies apply:
Associates in this role are expected to…