Medicaid Pharmacy Operations Specialist
2 weeks ago
The Medicaid Pharmacy Operations Specialist will play a pivotal role in managing pharmaceutical selections and utilization within the Medicaid framework. This position is integral to ensuring that our clinical programs, including Drug Utilization Review (DUR), Drug Interaction Screening (DIS), and formulary management, are executed effectively.
Key Responsibilities:
- Oversee the management of Medicaid formulary processes.
- Communicate formulary changes to members, stakeholders, and providers.
- Ensure the correct setup of formularies and claims processing.
- Act as a clinical pharmacy expert for pharmacy benefit management and operational teams.
- Guarantee compliance of Medicaid formularies with applicable state and federal regulations.
- Conduct thorough research and analysis of clinical data related to pharmaceuticals.
- Provide clinical support to fellow pharmacists, including guidance on DURs and therapeutic interventions.
Qualifications:
- Bachelor's degree in Pharmacy is required.
- A minimum of two years of experience in managed care pharmacy or completion of a pharmacy residency.
- Must be a licensed pharmacist with an active state license.
Preferred Skills:
- Doctor of Pharmacy (PharmD) is preferred.
- Experience in Medicaid formulary management is highly desirable.
- Excellent communication, analytical, and problem-solving skills.
- Proficiency in Microsoft Excel is advantageous.
Compensation and Benefits:
The salary range for this position is competitive and commensurate with experience. Elevance Health offers a comprehensive benefits package, including health insurance, retirement plans, and wellness programs. All benefits are subject to eligibility requirements.
Company Overview:
Elevance Health is dedicated to enhancing the health of our communities and simplifying healthcare delivery. We are committed to fostering a diverse and inclusive workplace where all employees can thrive.
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