Anthem, Inc. Pharmacist Clinical in San Francisco, California
SHIFT: Day Job
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 - IngenioRX (Mason OH; Las Vegas; California; St. Louis, MO)
Summary: Responsible for managing the selection and utilization of pharmaceuticals and supports core clinical programs such as DUR, DIS and formulary management.
Primary duties may include, but are not limited to:
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.
Must possess an active unrestricted state license to practice pharmacy as a Registered Pharmacist (RPh).
Minimum 2 years of managed care pharmacy, pharmacy benefit management (PBM) experience; or any combination of education and experience, which would provide an equivalent background required.
At least 3 years’ experience working with (PBM) pharmacy benefit management operations, or an equivalent background preferred.
Experience working with government programs (Medicare and/or Medicaid) strongly preferred.
Experience in prior authorizations preferred.
Specialty drug knowledge preferred.
Direct clinical program development experience preferred.
Must be available to work business hours 8am - 9pm EST., holidays, nights and weekends on a rotating schedule.
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.
Anthem, Inc. is ranked as one of America’s Most Admired Companies among health insurers by Fortune magazine and has been named a 2019 Best Employers for Diversity by Forbes. To learn more about our company and apply, please visit us at careers.antheminc.com. An Equal Opportunity Employer/Disability/Veteran. Anthem promotes the delivery of services in a culturally competent manner and considers cultural competency when evaluating applicants for all Anthem positions.
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