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Prior Authorization Clinical Pharmacist
Elevance HealthClinical Pharmacist evaluating pharmaceutical selection and utilization for Elevance Health. Supporting pharmacy programs and clinical guidance for medication efficacy and safety.
Posted 6/29/2026full-timeIndianapolis • Florida, Kentucky, Tennessee, Texas • 🇺🇸 United StatesJuniorMid-LevelWebsite
About the role
Key responsibilities & impact- Evaluating and managing the selection and utilization of pharmaceuticals
- Supports key clinical pharmacy programs, including Drug Utilization Review (DUR), Drug Information Services (DIS), and formulary management
- 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 based on medical necessity criteria
- 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
- Provides clinical guidance for therapeutic interventions, dosage conversions, and evidence-based medication use
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
- Requires a registered pharmacist
- Must possess an active unrestricted state license to practice pharmacy as a Registered Pharmacist (RPh)
- Current PR health certificate and a current PR Law 300 certificate are required for this position
Benefits
Comp & perks- merit increases
- paid holidays
- Paid Time Off
- incentive bonus programs
- medical, dental, vision
- short and long term disability benefits
- 401(k) +match
- stock purchase plan
- life insurance
- wellness programs
- financial education resources
ATS Keywords
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Hard Skills & Tools
Pharmaceutical EvaluationClinical Data AnalysisTherapeutic Class Review PreparationDosage Conversion GuidanceEvidence-Based Medication Use
Soft Skills
Clinical Resource CoordinationInterpersonal Communication
Certifications
Active Unrestricted State LicenseCurrent PR Health CertificateCurrent PR Law 300 Certificate