Manager, Pharmacy Clinical Operations

Anticipated End Date:

2025-06-27

Position Title:

Manager, Pharmacy Clinical Operations

Job Description:

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 Pharmacy Care Center (CPCC) is a clinical pharmacy call center that services Medicare, Medicaid, and the Commercial member populations. The members we reach out to have been identified as having gaps in care. Our goal is to close those gaps through education and assistance.

Title: Manager, Pharmacy Clinical Operations

Location: Atlanta, GA – 740 W Peachtree Street NW

Hybrid: This role requires associates to be in-office 3 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.

The Manager, Pharmacy Clinical Operations is responsible for developing and implementing clinical pharmacy programs to promote quality and cost-effective drug utilization.

How you will make an impact:

Primary duties may include, but are not limited to:

• Assists in the development of new clinical products.

• Oversees the Prior Authorization Center.

• Implements new prior authorization program.

• Manages clinical pharmacy operations and staff to ensure clients' objectives and deliverables are met.

• Oversees departmental processes, policies and procedures, training, and communication.

• Reports and analyzes prior authorization program trends.

• Ensures achievement of department goals and objectives.

• Hires, trains, coaches, counsels, and evaluates performance of direct reports.

Minimum Requirements:

• Requires BA/BS in Pharmacy or a PharmD and minimum of 5 years of experience in managed care, authorization, or related pharmacy experience; or any combination of education and experience, which would provide an equivalent background.

• Must possess an active, current and valid unrestricted state license (Rph) to practice pharmacy within the scope of practice in a state or territory of the United States.

• 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 United States.

Preferred Skills, Capabilities, and Experiences:

• Experience directing multi-functional teams; account management or customer service experience highly preferred.

• Proficient with Microsoft 360; Excel, Power Point, OneNote preferred.

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:

Manager

Workshift:

1st Shift (United States of America)

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.

How We Work

At Elevance Health, we are creating a culture that is designed to advance our strategy but will also lead to personal and professional growth for our associates. Our values and behaviors are the root of our culture. They are how we achieve our strategy, power our business outcomes and drive our shared success - for our consumers, our associates, our communities and our business.

We offer a range of market-competitive total rewards that include merit increases, paid holidays, Paid Time Off, and incentive bonus programs (unless covered by a collective bargaining agreement), medical, dental, vision, short and long term d