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Population Health Management Pharmacist
2 months ago
We are seeking a highly skilled Population Health Management Pharmacist to join our team at Elevance Health. As a key member of our pharmacy team, you will play a critical role in managing the selection and utilization of pharmaceuticals, supporting core clinical programs, and achieving quality and cost goals.
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.
- Provider education to support clinical pharmacy measures and reduce pharmacy costs.
- Build impactful relationships with providers to close the feedback loop between pharmacy and provider.
- 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).
- PharmD preferred.
- Experience in medication use quality improvement programs, analyzing pharmacy spend and trends, and Medicare Star Part D measures strongly desired.
- Experience working with Medicare and Commercial providers strongly preferred.
- PBM or Managed Care experience highly desired.
- Proficiency with Excel preferred.
Elevance Health is a health company dedicated to improving lives and communities – and making healthcare simpler. We offer a range of market-competitive total rewards, including merit increases, paid holidays, Paid Time Off, and incentive bonus programs. We operate in a Hybrid Workforce Strategy, with associates required to work at an Elevance Health location at least once per week. Candidates must reside within 50 miles or 1-hour commute each way of a relevant Elevance Health location. We are an Equal Employment Opportunity employer and 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.
