Population Health Management Pharmacist

20 hours ago

Cincinnati, Ohio, United States Elevance Health Full time
Job Summary

As a Population Health Management Pharmacist at Elevance Health, you will play a critical role in managing the selection and utilization of pharmaceuticals to achieve quality and cost goals. This position requires a strong clinical background and excellent communication skills to work with contracted providers and support core clinical programs.

Key Responsibilities
  • Research and synthesize detailed clinical data related to pharmaceuticals to assist contracted providers in achieving cost and quality goals.
  • Serve 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.
  • Prepare 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.
  • 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.
  • Provide education to support clinical pharmacy measures and reduce pharmacy costs.
  • Build impactful relationships with providers to close the feedback loop between pharmacy and provider.

Requirements
  • 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.
  • Registered pharmacist with an active unrestricted state license to practice pharmacy as a Registered Pharmacist (RPh).

Preferred Qualifications
  • PharmD.
  • Experience in medication use quality improvement programs, analyzing pharmacy spend and trends, and Medicare Star Part D measures.
  • Experience working with Medicare and Commercial providers.
  • PBM or Managed Care experience.
  • Proficiency with Excel.

About 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. 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. Candidates must reside within 50 miles or 1-hour commute each way of a relevant Elevance Health location. The health of our associates and communities is a top priority for Elevance Health. We require all new candidates in certain patient/member-facing roles to become vaccinated against COVID-19. If you are not vaccinated, your offer will be rescinded unless you provide an acceptable explanation. Elevance Health will also follow all relevant federal, state and local laws. Applicants who require accommodation to participate in the job application process may contact for assistance.

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