Prior Authorization Clinical Pharmacist

Prior Authorization Clinical Pharmacist (Virtual)

This role enables associates to work virtually full‑time, with required in‑person training sessions. The position supports key clinical pharmacy programs, including Drug Utilization Review, Drug Information Services, and formulary management.

• Research and synthesize detailed clinical data related to pharmaceuticals.
• Prepare and present therapeutic class reviews and drug monographs to the Pharmacy and Therapeutics Committee.
• Review and approve or deny coverage for pharmaceuticals as permitted by state or federal law, coordinating with internal stakeholders or health‑plan medical directors.
• Serve as a clinical resource on prospective, inpatient, and retrospective DURs and provide dosage conversion and clinical support for therapeutic interventions.
• Prepare information for network physicians and develop and communicate drug information and recommendations to clinical teams.

• BA/BS in Pharmacy required.
• Minimum 2 years of managed‑care pharmacy (PBM) experience or residency in lieu of work experience, or equivalent education/experience.
• Registered pharmacist with an active unrestricted state license to practice pharmacy.
• For those working in Puerto Rico as a member or patient‑facing in a clinical setting or in the Best Transportation unit, a current PR health certificate and a current PR Law
  300 certificate are required.
• PharmD preferred; PBM experience and prior authorization or specialty medication experience preferred.
• Must be located in a U.S. state or territory; remote work allowed only if a reasonable commuting distance from an Elevance Health office or if accommodation is granted by law.

Elevance Health is an Equal Employment Opportunity employer; 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.