Pharmacist Clinical - BioPlus Specialty Pharmacy

Anticipated End Date:

2025-05-23

Position Title:

Pharmacist Clinical - BioPlus Specialty Pharmacy

Job Description:

Be Part of an Extraordinary Team

BioPlus Specialty Pharmacy is now part of CarelonRx (formerly IngenioRx), and a proud member of the Elevance Health family of companies. Together, CarelonRx and BioPlus offer consumers and providers an unparalleled level of service that’s easy and focused on whole health. Through our distinct clinical expertise, digital capabilities, and broad access to specialty medications across a wide range of conditions, we deliver an elevated experience, affordability, and personalized support throughout the consumer’s treatment journey.

Build the Possibilities. Make an Extraordinary Impact.

Title: Pharmacist Clinical

Location: 4752 Research Dr., San Antonio, TX.

This role requires associates to work from the posted locations full-time, enabling consistent face-to-face collaboration, teamwork, and direct engagement. This policy promotes an environment built on in-person interaction, communication, and immediate support. Alternate locations may be considered.

Schedule: Monday-Friday, 9 AM - 6:00 PM CST. This position does not require evening or weekend work and does not involve any on-call duties.

The Pharmacist Clinical 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: 

Primary duties may include, but are not limited to: 

• Researches and synthesizes detailed clinical data related to pharmaceuticals. Prepares and presents therapeutic class reviews and drug monograph information to the Pharmacy and Therapeutics Committee.

• May review and approve or deny coverage for pharmaceuticals (as permitted by state/federal law or state/federal program contracts) based on medical necessity criteria, and coordinates with internal stakeholders or health plan medical directors as needed.

• 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, which would provide an equivalent background.

• Requires a registered pharmacist.

• Must possess an active unrestricted license in the state of Texas to practice pharmacy as a Registered Pharmacist (RPh).

• For associates working within Puerto Rico who are member 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.

Preferred Qualifications, Skills, and Experiences: 

• Minimum of 5 years of experience working as a Pharmacist in a retail or specialty pharmacy setting preferred.

• Experience with home infusion or preparing IV medication strongly preferred.

• PharmD preferred.

Unless expressly allowed by state or federal law, or regulation, must be located in a state or territory of the United States when conducting 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.

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 th