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Pharmacist Clinical Specialist
1 month ago
We are seeking a highly skilled Pharmacist Clinical Specialist to join our team at Elevance Health. As a key member of our clinical team, you will play a critical role in managing the selection and utilization of pharmaceuticals, supporting core clinical programs, and serving as a clinical resource to other pharmacists.
Key Responsibilities- Research and synthesize detailed clinical data related to pharmaceuticals.
- Review and approve or deny coverage for pharmaceuticals based on medical necessity criteria.
- Serve as a clinical resource to other pharmacists on areas such as prospective, inpatient, and retrospective DURs.
- Make prior authorization determinations and coordinate with Medical Directors and RNs in the UM Department.
- Provide evaluation of member's Rx needs and therapies through review of medication history.
- Determine potential barriers to compliance and identify solutions to overcome barriers.
- Ensure that providers understand appropriate use of current prescriptions.
- BA/BS in Pharmacy.
- Minimum of 2 years of managed care pharmacy (PBM) experience or residency in lieu of work experience.
- Registered pharmacist with an active unrestricted state license to practice pharmacy.
- PharmD preferred.
- Experience with direct patient counseling, provider interaction, and/or education preferred.
- Excellent PC and Microsoft Office skills preferred.
