Anthem Pharmacist Clinical (Mason, Va. Beach, Atlanta, St. Louis) - PS9559 in Atlanta, Georgia

Pharmacist Clinical (Mason, Va. Beach, Atlanta, St. Louis) - PS9559


Location: Atlanta, Georgia, United States

Field: Medical

Requisition #: PS9559

Post Date: 3 days ago

Your Talent. Our Vision. At Anthem, Inc. , it’s a powerful combination, and the foundation upon which we’re creating greater access to care for our members, greater value for our customers, and greater health for our communities. Join us and together we will drive the future of health care.

This is an exceptional opportunity to do innovative work that means more to you and those we serve at one of America's leading health benefits companies and a Fortune Top 50 Company.

Pharmacist Clinical (Mason, Va. Beach, Atlanta, St. Louis) - PS9559

Our Pharmacist Clinical position is responsible for pharmacy clinical program development, implementation, management, and quality oversight. Includes researching industry best practices, working with other departments on internal program analytics and outcomes analysis to drive program performance. This individual needs to be able to lead and manage program strategies, create and present communications to stakeholders and ensure that all programs are compliant with regulatory standards.

Responsibilities include:

Managing the selection and utilization of pharmaceuticals and supports core clinical programs such as DUR, DIS and formulary management. Also to include:

  • Medication Therapy Management Programs

  • Adherence

  • Gaps in Care

  • Safety

  • Drug Utilization Review

  • Other clinical quality outreach programs to help support pharmacy based health plan requirements and goals (i.e. STARS, HEDIS, CMS).

  • 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 Anthem 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 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 required.

  • Experience working with government programs (Medicare and/or Medicaid) required.

  • Current valid state license (in one of the 4 required locations above) to practice pharmacy as an RPh required.

  • PharmD strongly preferred.

  • Direct clinical program development experience preferred.

  • Strong oral, written and interpersonal communication skills, problem-solving skills, facilitation skills, and analytical skills strongly preferred.

Anthem, Inc. is ranked as one of America’s Most Admired Companies among health insurers by Fortune magazine and is a 2017 DiversityInc magazine Top 50 Company for Diversity. To learn more about our company and apply, please visit us at An Equal Opportunity Employer/Disability/Veteran.