- Maintain clinical criteria for prior authorization reviews for custom and standard criteria sets
- Collaborate with internal review teams to ensure client intent, client policies, and Carelon policies are captured and operating as expected
- Conduct outreach to quality assurance teams within Carelon as topics arise from the client
- Address prior authorization inquiries from clients by conducting initial research, outreach to internal teams for detailed reviews/assessments, and providing resolution feedback to the client
- Support Pharmacy & Therapeutics meetings
- Prepare, submit, and track clinical criteria resulting from Pharmacy & Therapeutics meetings
- Coordinate policy and utilization management updates with formulary
- Collaborate with client and internal partners to address client oversight/audit findings
- 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 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.
- The salary range is the range Elevance Health in good faith believes is the range of possible compensation for this role at the time of this posting. This range may be modified in the future and actual compensation may vary from posting based on geographic location, work experience, education, and/or skill level. Even within the range, the actual compensation will vary depending on the above factors as well as market/business considerations. No amount is considered to be wages or compensation until such amount is earned, vested, and determinable under the terms and conditions of the applicable policies and plans. The amount and availability of any bonus, commission, benefits, or any other form of compensation and benefits that are allocable to a particular employee remains in the Company's sole discretion unless and until paid and may be modified at the Company's sole discretion, consistent with the law.
-
Clinical Pharmacist
5 days ago
Stanford Health Care Palo Alto, United StatesIf you're ready to be part of our legacy of hope and innovation, we encourage you to take the first step and explore our current job openings. Your best is waiting to be discovered. · Rotating - 08 Hour (United States of America) · **This is a Stanford Health Care job.** · **A Br ...
-
Clinical Pharmacist
3 weeks ago
Stanford Health Care Palo Alto, United StatesIf you're ready to be part of our legacy of hope and innovation, we encourage you to take the first step and explore our current job openings. Your best is waiting to be discovered. · Day - 08 Hour (United States of America) · **This is a Stanford Health Care job.** · **A Brief O ...
-
Clinical Pharmacist
3 weeks ago
Stanford Health Care Palo Alto, United StatesIf you're ready to be part of our legacy of hope and innovation, we encourage you to take the first step and explore our current job openings. Your best is waiting to be discovered. · Day - 08 Hour (United States of America) · This is a Stanford Health Care job. · A Brief Overvie ...
-
Clinical Pharmacist
3 weeks ago
Stanford Health Care Palo Alto, United States Paid WorkIf you're ready to be part of our legacy of hope and innovation, we encourage you to take the first step and explore our current job openings. Your best is waiting to be discovered. · Rotating - 10 Hour (United States of America) · This is a Stanford Health Care job. · A Brief Ov ...
-
Clinical Pharmacist
5 days ago
Stanford Health Care Palo Alto, United StatesIf you're ready to be part of our legacy of hope and innovation, we encourage you to take the first step and explore our current job openings. Your best is waiting to be discovered. · Rotating - 08 Hour (United States of America) · **This is a Stanford Health Care job.** · **A Br ...
-
Clinical Pharmacist
3 weeks ago
Stanford Health Care Palo Alto, United StatesIf you're ready to be part of our legacy of hope and innovation, we encourage you to take the first step and explore our current job openings. Your best is waiting to be discovered. · Day - 08 Hour (United States of America) · **This is a Stanford Health Care job.** · **A Brief O ...
-
Clinical Pharmacist
3 weeks ago
Stanford Health Care Palo Alto, United StatesIf you're ready to be part of our legacy of hope and innovation, we encourage you to take the first step and explore our current job openings. Your best is waiting to be discovered. · Rotating - 08 Hour (United States of America) · This is a Stanford Health Care job. · A Brief Ov ...
-
Clinical Staff Pharmacist
1 week ago
Soliant Palo Alto, United StatesMinimum 1+ years pharmacy experience required. · Staff Pharmacist needed near Palo Alto, California · Soliant has a need for a staff pharmacist f recent hospital pharmacist with recent experience. Should have the ability to work day/evening shifts. Applicants must have a clear a ...
-
Clinical Pharmacist II
4 days ago
Lucile Packard Children's Hospital Stanford Palo Alto, United StatesPharmacy · 1.0 FTE, 8 Hour Rotating Shift · At Stanford Children's Health, we know world-renowned care begins with world-class caring. That's why we combine advanced technologies and breakthrough discoveries with family-centered care. It's why we provide our caregivers with con ...
-
Clinical Pharmacist II
3 weeks ago
Lucile Packard Children's Hospital Palo Alto, United StatesPharmacy · 1.0 FTE, 8 Hour Rotating Shift · At Stanford Children's Health, we know world-renowned care begins with world-class caring. That's why we combine advanced technologies and breakthrough discoveries with family-centered care. It's why we provide our caregivers with con ...
-
Inpatient Clinical Pharmacist I
3 weeks ago
Soliant Palo Alto, United StatesMinimum 1+ years pharmacy experience required. · As an Inpatient Pharmacist, you'll serve as a crucial member of the healthcare team, specializing in medication management within hospital settings. Your primary responsibility is to ensure the safe and effective use of medications ...
-
Clinical Pharmacist, Oncology
3 weeks ago
Sutter Health Palo Alto, United StatesOrganization: · PAMF-Palo Alto Medical Foundation PAD · Position Overview: · Works independently and in consultation with physicians and other health care providers across the health care continuum to ensure appropriate medication therapy for individual patients. Uses patient int ...
-
Clinical Pharmacist
2 weeks ago
Stanford Health Care Palo Alto, United States Paid WorkIf you're ready to be part of our legacy of hope and innovation, we encourage you to take the first step and explore our current job openings. Your best is waiting to be discovered. · Rotating - 08 Hour (United States of America) · This is a Stanford Health Care job. · A Brief Ov ...
-
Relief Clinical Pharmacist I
3 weeks ago
Lucile Packard Children's Hospital Stanford Palo Alto, United StatesPharmacy · 0.001 FTE, 8 Hour Rotating Shift · At Stanford Children's Health, we know world-renowned care begins with world-class caring. That's why we combine advanced technologies and breakthrough discoveries with family-centered care. It's why we provide our caregivers with c ...
-
Ambulatory Clinical Pharmacist II
2 days ago
Lucile Packard Children's Hospital Stanford Palo Alto, United StatesPharmacy · 1.0 FTE, 8 Hour Day Shift · At Stanford Children's Health, we know world-renowned care begins with world-class caring. That's why we combine advanced technologies and breakthrough discoveries with family-centered care. It's why we provide our caregivers with continui ...
-
Relief Clinical Pharmacist I
3 weeks ago
Lucile Packard Children's Hospital Palo Alto, United StatesPharmacy · 0.001 FTE, 8 Hour Rotating Shift · At Stanford Children's Health, we know world-renowned care begins with world-class caring. That's why we combine advanced technologies and breakthrough discoveries with family-centered care. It's why we provide our caregivers with c ...
-
Ambulatory Clinical Pharmacist III
3 weeks ago
Sutter Health Palo Alto, United StatesOrganization: · ABSMC-Alta Bates Herrick Campus · Position Overview: · Delivers pharmaceutical care through the provision of patient-centered clinical service, medication information, education, medication preparation and distribution that ensures safe, effective, and cost effici ...
-
Ambulatory Clinical Pharmacist II
3 weeks ago
Lucile Packard Children's Hospital Palo Alto, United StatesPharmacy · 1.0 FTE, 8 Hour Day Shift · At Stanford Children's Health, we know world-renowned care begins with world-class caring. That's why we combine advanced technologies and breakthrough discoveries with family-centered care. It's why we provide our caregivers with continui ...
-
Clinical Pharmacist
1 week ago
Washington Hospital Healthcare System Fremont, United StatesDescription · Salary Range : $ $117.62 · Summary of Duties : Responsible for reviewing physician medication orders (EPIC CPOE) for appropriateness cost-effectiveness, monitor and adjust patient drug therapies according to many pharmacy driven protocols, and provide drug informat ...
-
Outpatient Clinical Pharmacist
4 weeks ago
Department Of Veterans Affairs Palo Alto, United States Full timeSummary · The Outpatient Clinical Pharmacist is responsible for the daily professional and administrative operations of the Outpatient Pharmacy at the VA Palo Alto Health Care System (VAPAHCS). Under the direction of the Outpatient Pharmacy Supervisor and in counsel with Pharmacy ...
Clinical Pharmacist - PALO ALTO, United States - Elevance Health
Description
Clinical Pharmacist - CarelonRx
Location: The ideal candidate will live within 50 miles of one of our pulse point locations and will work on a hybrid work model (1-2 days per week in the office).
A proud member of the Elevance Health family of companies, CarelonRx (formerly IngenioRx) leverages the power of new technologies and a strong, clinical-first lens, to deliver member-centered, lasting pharmacy care.
The Clinical Pharmacist is responsible for managing the selection and utilization of pharmaceuticals and supports core clinical programs such as DUR, DIS, and formulary management.
How you will make an impact:
Minimum Requirements:
Preferred Qualifications, Skills, and Experiences:
Unless expressly allowed by state or federal law, or regulation, must be located in a state or territory of the United States when conducting a utilization review or an appeals consideration and cannot be located on a US military base, vessel, or any embassy located in or outside of the US, unless they are command-sanctioned activities. For URAC-accredited areas, the following professional competencies apply: Associates in this role are expected to have strong oral, written, and interpersonal communication skills, problem-solving skills, facilitation skills, and analytical skills. For associates working within Puerto Rico who are members or patient-facing either in a clinical setting or in the Best Transportation unit, a current PR health certificate, and a current PR Law 300 certificate are required for this position.
For candidates working in person or remotely in the below locations, the salary* range for this specific position is $112,000 to $201,600.
Locations: California; Colorado; Hawaii; Nevada; New York; Washington State; Jersey City, NJ
In addition to your salary, Elevance Health offers benefits such as a comprehensive benefits package, incentive and recognition programs, equity stock purchase, and 401k contribution (all benefits are subject to eligibility requirements). The salary offered for this specific position is based on a number of legitimate, non-discriminatory factors set by the company. The company is fully committed to ensuring equal pay opportunities for equal work regardless of gender, race, or any other category protected by federal, state, and local pay equity laws.
