Clinical Pharmacist – Data Analytics

Elevance Health

Clinical Pharmacist managing pharmaceutical utilization and supporting data analytics for Elevance Health. Collaborating with various teams to enhance member experience and deliver financial outcomes.

Posted 6/10/2026full-timeCincinnati • Illinois, New Jersey, Ohio • 🇺🇸 United StatesJuniorMid-Level💰 $119,360 - $205,896 per yearWebsite

ATS Keywords

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Applicant Tracking System Keywords

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Hard Skills

clinical data analysisutilization management strategiesprior authorization data analysisfinancial impact forecastingperformance metrics reportingtherapeutic class reviewsdrug monograph preparationdosage conversionpharmaceutical data analyticsmanaged care pharmacy

Soft Skills

oral communicationwritten communicationinterpersonal communicationproblem-solvingfacilitationanalytical skillscross-functional collaborationrelationship buildingdecision-makingorganizational skills

Certifications & Qualifications

registered pharmacistPharmacist licensePharmD

Industry Keywords

managed carepharmacy benefit managementutilization managementprior authorizationclinical resourcePharmacy and Therapeutics CommitteeDURsfinancial outcomesmember experienceoperational efficiency

About the role

Key responsibilities & impact

Work location - Hybrid 1 This role requires associates to be in-office 1 - 2 days per week
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

Requirements

What you’ll need

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
PharmD preferred
Managed care experience is strongly preferred
Previous experience in pharmaceutical data analytics is preferred
MBM and/or PBM experience is also preferred
Associates in this role are expected to have strong oral, written and interpersonal communication skills, problem-solving skills, facilitation skills, and analytical skills

Benefits

Comp & perks

comprehensive benefits package
incentive and recognition programs
equity stock purchase
401k contribution