Elevance Health
Medicaid Formulary Pharmacist Clinical - CarelonRx
Elevance Health, Santa Ana, California, United States, 92725
Position Title
Medicaid Formulary Pharmacist Clinical - CarelonRx
Location and Work Arrangement This role requires associates to be in‑office 1‑2 days per week, fostering collaboration and connectivity, while providing flexibility to support productivity and work‑life balance. Alternate locations may be considered. Candidates not within a reasonable commuting distance from the posting location(s) will not be considered unless an accommodation is granted as required by law.
Responsibilities
Leads Medicaid formulary management processes.
Responsible for all member, stakeholder, and provider communications regarding formulary changes.
Ensures appropriate formulary set‑up and claims adjudication.
Serves as a clinical pharmacy resource to pharmacy benefit management and pharmacy operations teams.
Ensures compliance of the Medicaid formularies with state/federal mandates and contractual agreements.
Serves as a clinical resource to other pharmacists on areas such as prospective, inpatient, and retrospective DURs and provides dosage conversion and clinical support for therapeutic interventions.
Prepares information for network physicians.
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 provides 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 strongly preferred.
Formulary management experience in Medicaid strongly preferred.
Strong oral, written, and interpersonal communication skills, problem‑solving skills, facilitation skills, and analytical skills.
Proficiency in Microsoft Excel desired.
Experience with Python, SAS, or SQL preferred.
Salary and Locations For candidates working in person or virtually in the below location(s), the salary* range for this specific position is $114,800 to $198,030.
Locations: Cleveland, OH; District of Columbia (Washington, DC); Illinois; Maryland; Massachusetts; Nevada; New Jersey.
Job Details Job Level: Non‑Management Exempt
Workshift: 1st Shift (United States of America)
Job Family: MED > Licensed/Registered Pharmacist/Pharmacy Technician
Equal Employment Opportunity Elevance Health is 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, and local laws. Applicants who require accommodation to participate in the job application process may contact elevancehealthjobssupport@elevancehealth.com for assistance. Qualified applicants with arrest or conviction records will be considered for employment in accordance with all federal, state, and local laws, including, but not limited to, the Los Angeles County Fair Chance Ordinance and the California Fair Chance Act.
#J-18808-Ljbffr
Location and Work Arrangement This role requires associates to be in‑office 1‑2 days per week, fostering collaboration and connectivity, while providing flexibility to support productivity and work‑life balance. Alternate locations may be considered. Candidates not within a reasonable commuting distance from the posting location(s) will not be considered unless an accommodation is granted as required by law.
Responsibilities
Leads Medicaid formulary management processes.
Responsible for all member, stakeholder, and provider communications regarding formulary changes.
Ensures appropriate formulary set‑up and claims adjudication.
Serves as a clinical pharmacy resource to pharmacy benefit management and pharmacy operations teams.
Ensures compliance of the Medicaid formularies with state/federal mandates and contractual agreements.
Serves as a clinical resource to other pharmacists on areas such as prospective, inpatient, and retrospective DURs and provides dosage conversion and clinical support for therapeutic interventions.
Prepares information for network physicians.
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 provides 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 strongly preferred.
Formulary management experience in Medicaid strongly preferred.
Strong oral, written, and interpersonal communication skills, problem‑solving skills, facilitation skills, and analytical skills.
Proficiency in Microsoft Excel desired.
Experience with Python, SAS, or SQL preferred.
Salary and Locations For candidates working in person or virtually in the below location(s), the salary* range for this specific position is $114,800 to $198,030.
Locations: Cleveland, OH; District of Columbia (Washington, DC); Illinois; Maryland; Massachusetts; Nevada; New Jersey.
Job Details Job Level: Non‑Management Exempt
Workshift: 1st Shift (United States of America)
Job Family: MED > Licensed/Registered Pharmacist/Pharmacy Technician
Equal Employment Opportunity Elevance Health is 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, and local laws. Applicants who require accommodation to participate in the job application process may contact elevancehealthjobssupport@elevancehealth.com for assistance. Qualified applicants with arrest or conviction records will be considered for employment in accordance with all federal, state, and local laws, including, but not limited to, the Los Angeles County Fair Chance Ordinance and the California Fair Chance Act.
#J-18808-Ljbffr