Clinical Pharmacist

4 weeks ago

Palo Alto, California, United States Elevance Health Full time

Clinical Pharmacist - CarelonRx

Location: The ideal candidate will live within 50 miles of one of our pulse point locations and will work on a hybrid work model (1-2 days per week in the office).

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

The Clinical Pharmacist 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:

  • Maintain clinical criteria for prior authorization reviews for custom and standard criteria sets
  • Collaborate with internal review teams to ensure client intent, client policies, and Carelon policies are captured and operating as expected
  • Conduct outreach to quality assurance teams within Carelon as topics arise from the client
  • Address prior authorization inquiries from clients by conducting initial research, outreach to internal teams for detailed reviews/assessments, and providing resolution feedback to the client
  • Support Pharmacy & Therapeutics meetings
  • Prepare, submit, and track clinical criteria resulting from Pharmacy & Therapeutics meetings
  • Coordinate policy and utilization management updates with formulary
  • Collaborate with client and internal partners to address client oversight/audit findings

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, that 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 Qualifications, Skills, and Experiences:

  • PharmD preferred.

Unless expressly allowed by state or federal law, or regulation, must be located in a state or territory of the United States when conducting a 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. 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. For associates working within Puerto Rico who are members or patient-facing either in a clinical setting or in the Best Transportation unit, a current PR health certificate, and a current PR Law 300 certificate are required for this position.

For candidates working in person or remotely in the below locations, the salary* range for this specific position is $112,000 to $201,600.

Locations: California; Colorado; Hawaii; Nevada; New York; Washington State; Jersey City, NJ

In addition to your salary, Elevance Health offers benefits such as a comprehensive benefits package, incentive and recognition programs, equity stock purchase, and 401k contribution (all benefits are subject to eligibility requirements). The salary offered for this specific position is based on a number of legitimate, non-discriminatory factors set by the company. The company is fully committed to ensuring equal pay opportunities for equal work regardless of gender, race, or any other category protected by federal, state, and local pay equity laws.

  • The salary range is the range Elevance Health in good faith believes is the range of possible compensation for this role at the time of this posting. This range may be modified in the future and actual compensation may vary from posting based on geographic location, work experience, education, and/or skill level. Even within the range, the actual compensation will vary depending on the above factors as well as market/business considerations. No amount is considered to be wages or compensation until such amount is earned, vested, and determinable under the terms and conditions of the applicable policies and plans. The amount and availability of any bonus, commission, benefits, or any other form of compensation and benefits that are allocable to a particular employee remains in the Company's sole discretion unless and until paid and may be modified at the Company's sole discretion, consistent with the law.

  • Outpatient Clinical Pharmacist

    2 months ago

    Palo Alto, California, United States Department Of Veterans Affairs Full time

    Summary The Outpatient Clinical Pharmacist is responsible for the daily professional and administrative operations of the Outpatient Pharmacy at the VA Palo Alto Health Care System (VAPAHCS). Under the direction of the Outpatient Pharmacy Supervisor and in counsel with Pharmacy Leadership, the Pharmacist has full responsibility for the daily management and...

  • Outpatient Clinical Pharmacist

    1 week ago

    Palo Alto, California, United States Department Of Veterans Affairs Full time

    Summary The Outpatient Clinical Pharmacist is responsible for the daily professional and administrative operations of the Outpatient Pharmacy at the VA Palo Alto Health Care System (VAPAHCS). Under the direction of the Outpatient Pharmacy Supervisor and in counsel with Pharmacy Leadership, the Pharmacist has full responsibility for the daily management and...

  • Pharmacist (Inpatient Clinical Specialist)

    3 weeks ago

    Palo Alto, California, United States Department Of Veterans Affairs Full time

    Summary This position is eligible for the Education Debt Reduction Program (EDRP), a student loan payment reimbursement program. You must meet specific individual eligibility requirements in accordance with VHA policy and submit your EDRP application within four months of appointment. Approval, award amount (up to $200,000) and eligibility period (one to...

  • Pharmacist (Inpatient Clinical Specialist)

    1 week ago

    Palo Alto, California, United States Department Of Veterans Affairs Full time

    Summary This position is eligible for the Education Debt Reduction Program (EDRP), a student loan payment reimbursement program. You must meet specific individual eligibility requirements in accordance with VHA policy and submit your EDRP application within four months of appointment. Approval, award amount (up to $200,000) and eligibility period (one to...

  • Clinical Pharmacist

    2 weeks ago

    Palo Alto, California, United States Stanford Health Care Full time

    If you're ready to be part of our legacy of hope and innovation, we encourage you to take the first step and explore our current job openings. Your best is waiting to be discovered.Rotating - 08 Hour (United States of America)This is a Stanford Health Care job.A Brief OverviewAs a member of a multidisciplinary health care team, the clinical pharmacist...

  • Clinical Pharmacist

    1 week ago

    Palo Alto, California, United States Stanford Health Care Full time

    If you're ready to be part of our legacy of hope and innovation, we encourage you to take the first step and explore our current job openings. Your best is waiting to be discovered.Rotating - 08 Hour (United States of America)This is a Stanford Health Care job.A Brief OverviewAs a member of a multidisciplinary health care team, the clinical pharmacist...

  • Ambulatory Clinical Pharmacist II

    3 weeks ago

    Palo Alto, California, United States Lucile Packard Children's Hospital Stanford Full time

    Pharmacy 1.0 FTE, 8 Hour Day Shift - 8 Months Fixed Term At Stanford Children's Health, we know world-renowned care begins with world-class caring. That's why we combine advanced technologies and breakthrough discoveries with family-centered care. It's why we provide our caregivers with continuing education and state-of-the-art facilities, like the newly...

  • Ambulatory Clinical Pharmacist II

    1 week ago

    Palo Alto, California, United States Lucile Packard Children's Hospital Stanford Full time

    Pharmacy 1.0 FTE, 8 Hour Day Shift - 8 Months Fixed Term At Stanford Children's Health, we know world-renowned care begins with world-class caring. That's why we combine advanced technologies and breakthrough discoveries with family-centered care. It's why we provide our caregivers with continuing education and state-of-the-art facilities, like the newly...

  • Clinical Pharmacist

    3 weeks ago

    Palo Alto, California, United States Stanford Health Care Full time

    If you're ready to be part of our legacy of hope and innovation, we encourage you to take the first step and explore our current job openings. Your best is waiting to be discovered. Night - 10 Hour (United States of America)SHC pharmacy is a place of innovation, providing the highest level of patient care, with incredible colleagues. We are constantly...

  • Clinical Pharmacist

    3 weeks ago

    Palo Alto, California, United States Stanford Health Care Full time

    If you're ready to be part of our legacy of hope and innovation, we encourage you to take the first step and explore our current job openings. Your best is waiting to be discovered. Rotating - 08 Hour (United States of America)SHC pharmacy is a place of innovation, providing the highest level of patient care, with incredible colleagues. We are constantly...

  • Clinical Pharmacist

    1 week ago

    Palo Alto, California, United States Stanford Health Care Full time

    If you're ready to be part of our legacy of hope and innovation, we encourage you to take the first step and explore our current job openings. Your best is waiting to be discovered. Night - 10 Hour (United States of America)SHC pharmacy is a place of innovation, providing the highest level of patient care, with incredible colleagues. We are constantly...

  • Pharmacist (Harm Reduction Coordinator Clinical Practitioner)

    3 weeks ago

    Palo Alto, California, United States Department Of Veterans Affairs Full time

    Summary This position is eligible for the Education Debt Reduction Program (EDRP), a student loan payment reimbursement program. You must meet specific individual eligibility requirements in accordance with VHA policy and submit your EDRP application within four months of appointment. Approval, award amount (up to $200,000) and eligibility period (one to...

  • Pharmacist (Harm Reduction Coordinator Clinical Practitioner)

    1 week ago

    Palo Alto, California, United States Department Of Veterans Affairs Full time

    Summary This position is eligible for the Education Debt Reduction Program (EDRP), a student loan payment reimbursement program. You must meet specific individual eligibility requirements in accordance with VHA policy and submit your EDRP application within four months of appointment. Approval, award amount (up to $200,000) and eligibility period (one to...

  • Ambulatory Clinical Pharmacist III

    3 weeks ago

    Palo Alto, California, United States Sutter Health Full time

    Organization:ABSMC-Alta Bates Herrick CampusPosition Overview:Delivers pharmaceutical care through the provision of patient-centered clinical service, medication information, education, medication preparation and distribution that ensures safe, effective, and cost efficient medication therapy. Exercises sound judgment, and developed clinical skills to...

  • Ambulatory Clinical Pharmacist III

    1 week ago

    Palo Alto, California, United States Sutter Health Full time

    Organization:ABSMC-Alta Bates Herrick CampusPosition Overview:Delivers pharmaceutical care through the provision of patient-centered clinical service, medication information, education, medication preparation and distribution that ensures safe, effective, and cost efficient medication therapy. Exercises sound judgment, and developed clinical skills to...

  • Ambulatory Clinical Pharmacist Lead

    3 weeks ago

    Palo Alto, California, United States Sutter Health Full time

    Organization:ABSMC-Alta Bates Herrick CampusPosition Overview:Organizes and coordinates the day-to-day actives of the Pharmacy department, and assumes the responsibility for compliance with all federal and state laws. Serves as the liaison between the department and staff, physicians, patients, family and other hospital staff. Delivers pharmaceutical care...

  • Ambulatory Clinical Pharmacist Lead

    1 week ago

    Palo Alto, California, United States Sutter Health Full time

    Organization:ABSMC-Alta Bates Herrick CampusPosition Overview:Organizes and coordinates the day-to-day actives of the Pharmacy department, and assumes the responsibility for compliance with all federal and state laws. Serves as the liaison between the department and staff, physicians, patients, family and other hospital staff. Delivers pharmaceutical care...

  • Clinical Pharmacist Ambulatory

    3 weeks ago

    Palo Alto, California, United States Stanford Health Care Full time

    If you're ready to be part of our legacy of hope and innovation, we encourage you to take the first step and explore our current job openings. Your best is waiting to be discovered. Day - 10 Hour (United States of America)SHC pharmacy is a place of innovation, providing the highest level of patient care, with incredible colleagues. We are constantly growing...

  • Clinical Pharmacist Ambulatory

    1 week ago

    Palo Alto, California, United States Stanford Health Care Full time

    If you're ready to be part of our legacy of hope and innovation, we encourage you to take the first step and explore our current job openings. Your best is waiting to be discovered. Day - 10 Hour (United States of America)SHC pharmacy is a place of innovation, providing the highest level of patient care, with incredible colleagues. We are constantly growing...

  • Clinical Pharmacist – Hematology/Oncology

    3 weeks ago

    Palo Alto, California, United States Stanford Health Care Full time

    If you're ready to be part of our legacy of hope and innovation, we encourage you to take the first step and explore our current job openings. Your best is waiting to be discovered. Rotating - 08 Hour (United States of America)SHC pharmacy is a place of innovation, providing the highest level of patient care, with incredible colleagues. We are constantly...