Clinical Pharmacist - Data Analytics

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Anticipated End Date: 2026-06-30 Position Title: Clinical Pharmacist - Data Analytics Job Description: Work location - Hybrid 1 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. Alternate locations may be considered if candidates reside within a commuting distance from an office. 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 - Data Analytics is 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: Researches and synthesizes detailed clinical data related to pharmaceuticals. Proactively identify utilization management (UM) strategies that enhance the member experience while delivering positive financial outcomes. Analyze prior authorization (PA) data and trends to develop recommendations, considering rebates, member impact, and operational efficiency. Monitor and evaluate UM performance to ensure effectiveness and alignment with organizational goals. Report on PA performance metrics to support data-driven decision-making across teams. Forecast the potential financial and administrative impact associated with UM initiatives. Track the financial impact of recently implemented UM. Build and maintain strong cross-functional relationships with Trade, Formulary, Clinical, and Actuarial teams to collaboratively develop and implement UM solutions Supports 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 internal stakeholders 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. Position 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. Current unrestricted Pharmacist license in applicable state(s) required. Preferred qualifications, skills, and experiences: PharmD preferred. Managed care experience is strongly preferred. Previous experience in pharmaceutical data analytics is preferred. MBM and/or PBM experience is also preferred. 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 US, unless they are command-sanctioned activities. 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. For candidates working in person or virtually in the below locations, the salary* range for this specific position is $119,360 to $205,896 Location(s): Illinois, New Jersey, Cleveland, OH, Columbus, OH In addition to your salary, Elevance Health offers benefits such as a comprehensive benefits package, incentive and recognition programs, equity stock purchase and 401k contribution (all benefits are subject to eligibility requirements). The salary offered for this specific position is based on a number of legitimate, non-discriminatory factors set by the Company. The Company is fully committed to ensuring equal pay opportunities for equal work regardless of gender, race, or any other category protected by federal, state, and local pay equity laws. * The salary range is the range Elevance Health in good faith believes is the range of possible compensation for this role at the time of this posting. This range may be modified in the future and actual compensation may vary from posting based on geographic location, work experience, education, and/or skill level. Even within the range, the actual compensation will vary depending on the above factors as well as market/business considerations. No amount is wages or compensation until such amount is earned, vested, and determinable under the terms and conditions of th