The Pharmacist Clinical Resident is responsible for various operational or clinical aspects of the Amerigroup pharmacy program, including Prior Authorizations, Medication Therapy Management (MTM), Lock-in, and Drug Utilization Review (DUR) programs.

Location: This position will work a hybrid model (remote and office). The Ideal candidate will live within 50 miles of an Elevance Health PulsePoint location.

Primary duties may include, but are not limited to:

• Performs daily clinical prior authorizations and coverage determinations for Medicaid and Medicare.

• Completes work related to the Pharmacy and Therapeutics Committee including therapeutic class reviews, policy review, drug monographs, and formulary recommendations.

• Completes a year-long project targeted at improving member care through proper medication management.

• Participates in the pharmaceutical care management process through reviewing member profiles, recommending members for lock-in, case management or disease management.

• Responds to and resolves issues related to member/provider complaints, claims processing issues and appeals.

Minimum Requirements:

• Requires managed care experience; or any combination of education and experience, which would provide an equivalent background.

• Requires graduation from an accredited school of Pharmacy.

• Will be required to obtain current valid state license to practice as an Registered Pharmacist (RPh) within 90 days of hire. Knowledge of Managed Pharmacy Environment from an HMO or PBM preferred. PharmD preferred

Preferred Qualifications for Clinical Pharmacist -Resident:

• Participated in residency application process with Elevance Health and selected for final interview process.

• Graduation from a School of Pharmacy, PharmD by start date.

• Requires a Registered Pharmacist; must possess an active, unrestricted state license to practice pharmacy as an (RPh) or able to obtain one within 90 days of hire.

• Knowledge of Managed Pharmacy Environment from an HMO or PBM preferred. PharmD preferred

• Strong interest in managed care pharmacy.

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 disability benefits, 401(k) +match, stock purchase plan, life insurance, wellness programs and financial education resources, to name a few.

Elevance Health operates in a Hybrid Workforce Strategy. Unless specified as primarily virtual by the hiring manager, associates are required to work at an Elevance Health location at least once per week, and potentially several times per week. Specific requirements and expectations for time onsite will be discussed as part of the hiring process. Candidates must reside within 50 miles or 1-hour commute each way of a relevant Elevance Health location.

The health of our associates and communities is a top priority for Elevance Health. We require all new candidates in certain patient/member-facing roles to become vaccinated against COVID-19 and Influenza. If you are not vaccinated, your offer will be rescinded unless you provide an acceptable explanation. Elevance Health will also follow all relevant federal, state and local laws.

Elevance Health is an Equal Employment Opportunity employer and all qualified applicants will receive consideration for employment without regard to age, citizenship status, color, creed, disability, ethnicity, genetic information, gender (including gender identity and gender expression), marital status, national origin, race, religion, sex, sexual orientation, veteran status or any other status or condition protected by applicable federal, state, or local laws. Applicants who require accommodation to participate in the job application process may contact elevancehealthjobssupport@elevancehealth.com for assistance.

Qualified applicants with arrest or conviction records will be considered for employment in accordance with all federal, state, and local laws, including, but not limited to, the Los Angeles County Fair Chance Ordinance and the California Fair Chance Act.