Clinical Pharmacist, Population Health

Anticipated End Date:

2025-10-01

Position Title:

Clinical Pharmacist, Population Health

Job Description:

Be Part of an Extraordinary Team

CarelonRx is a proud member of the Elevance Health family of companies providing unparalleled level of service in pharmacy benefits. By leveraging the power of new technologies, our strong, clinical-first lens and deep pharmacy expertise, we are actively defining our innovative role in the industry.

Build the Possibilities. Make an Extraordinary Impact.

Title: Clinical Pharmacist, Population Health

Location(s): Mason, OH, Cincinnati, OH, Seven Hills, OH, Columbus, OH

Hybrid: 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.

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.

The Clinical Pharmacist, Population Health is responsible for managing the selection and utilization of pharmaceuticals and supports core clinical programs such as DUR, DIS, and formulary management. This role also involves providing pharmacy support to Medicare, Commercial, and Medicaid providers, focusing on improving quality (STAR and HEDIS) and cost measures. You will work closely with providers engaged in value-based care, influencing prescribing practices to improve members' health and reduce the total cost of care.

How you will make an impact: 

• Researches and synthesizes detailed clinical data related to pharmaceuticals to assist contracted providers in achieving cost and quality goals.

• Evaluate pharmacy quality program data and work with stakeholders to identify, prioritize, and implement strategies to optimize medication use and manage pharmacy spending effectively.

• During practice-level discussions, act as a subject matter expert in pharmacy-related clinical measures for value-based care agreements.

• Work to improve pharmacy quality by staying up to date on STAR and HEDIS measures.

• Provider education to support clinical pharmacy measures and reduce pharmacy costs.

• Build impactful relationships with providers to close the feedback loop between pharmacy and provider.

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 state license 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 Skills, Capabilities, and Experiences:

• PharmD preferred.

• Experience with Medicaid programs, particularly in Ohio preferred.

• Microsoft Excel experience strongly preferred.

• PBM or managed care experience strongly preferred.

• Passionate about building relationships with external provider partners to improve member health 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:

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