Managed Care Pharmacy Resident

Anticipated End Date:

2025-11-21

Position Title:

Managed Care Pharmacy Resident

Job Description:

Managed Care Pharmacy Resident

Location: 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. This approach combines structured office engagement with the autonomy of virtual work, promoting a dynamic and adaptable workplace. Alternate locations may be considered.

Please note that per our policy on hybrid/virtual work, candidates not within a reasonable commuting distance from the posting location(s) will not be considered for employment, unless an accommodation is granted as required by law.

Be Part of an Extraordinary Team 

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 Managed Care Pharmacy Resident will be responsible for various operational or clinical aspects of the CarelonRx pharmacy program, including Prior Authorizations, Medication Therapy Management (MTM), Lock-in, and Drug Utilization Review (DUR) programs.

How you will make an impact:

• Complete work related to the Pharmacy and Therapeutics Committee including therapeutic class reviews, policy review, drug monographs, and formulary recommendations.
• Develop strategies to drive formulary utilization and optimization.
• Collaborate with account management teams to analyze drug usage data, support initiatives to optimize pharmacy spend and improve member and client outcomes.
• Complete a year-long project targeted at improving member care through proper medication management.
• Perform weekly clinical prior authorizations and coverage determinations for Medicaid and Medicare.
• Participate in the pharmaceutical care management process through reviewing member profiles, recommending members for lock-in, case management or disease management.
• Respond to and resolve issues related to member/provider complaints, claims processing issues and appeals.

Minimum requirements:

• PharmD from an accredited school of pharmacy by start date.
• Registered Pharmacist; must possess an active, unrestricted state license to practice pharmacy as an RPh or able to obtain one within 90 days of start date
• Authorized to work in the U.S. without future visa sponsorship requirements
• Completion of application which also includes letter of intent and curriculum vitae (CV)
• Three letters of recommendation and official pharmacy school transcripts emailed directly to PharmacyResidency@ElevanceHealth.com

Preferred Skills, Capabilities and Experiences:

• Managed care experience; or any combination of education and experience, which would provide an equivalent background
• Familiarity with Microsoft Office Products (Word, Excel, PowerPoint, etc.)
• Excellent communication skills, both written and oral
• Excellent problem-solving, analytical and organizational skills
• Excellent public speaking and presentation skills
• Strong interest in managed care pharmacy

Application Process:

• Application, letter of intent and CV due December 15, 2025, at 11:59 pm EST.
• Three letters of recommendation and official pharmacy school transcripts emailed to PharmacyResidency@ElevanceHealth.com by December 15, 2025, at 11:59 pm EST.
• Preliminary interviews first week of January 2026
• Full day interviews about the third week of January 2026

Job Level:

Non-Management Exempt

Workshift:

Job Family:

MED > Licensed/Registered Pharmacist/Pharmacy Technician

Please be advised that Elevance Health only accepts resumes for compensation from agencies that have a signed agreement with Elevance Health. Any unsolicited resumes, including those submitted to hiring managers, are deemed to be the property of Elevance Health.

Who We Are

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.