Population Health Management Pharmacist - CarelonRx

Population Health Management Pharmacist - CarelonRx

Population Health Management Pharmacist (Clinical Pharmacist)

Location(s): Indianapolis, IN, Mason, OH, Louisville, KY

Hybrid: 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.

The Population Health Management Pharmacist (Clinical Pharmacist) oversees clinical program quality and appropriate medication use for in-scope provider groups to support quality and cost goals.

How you will make an impact:

• Researches and synthesizes detailed clinical data related to pharmaceuticals to assist contracted providers in achieving cost and quality goals.
• Serves as a clinical resource to other pharmacists and contracted providers in areas such as prospective, inpatient, and retrospective DURs and clinical support for therapeutic interventions.
• Prepares information for network physicians using data within provider tools including Excel.
• Evaluate pharmacy quality program data and work with stakeholders to identify, prioritize, and implement strategies to optimize medication use and manage pharmacy spending effectively.
• During practice-level discussions, act as a subject matter expert in pharmacy-related clinical measures for value-based care agreements.
• Work to improve pharmacy quality by staying up to date on STAR and HEDIS measures.
• Provider education to support clinical pharmacy measures and reduce pharmacy costs.
• Build impactful relationships with providers to close the feedback loop between pharmacy and provider.
• Act as a pharmacy SME to internal and leadership teams

Minimum 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.
• Must possess an active unrestricted state license to practice pharmacy as a Registered Pharmacist (RPh).

Preferred Qualifications, Skills, and Experiences:

• PharmD preferred.
• Experience in medication use quality improvement programs, analyzing pharmacy spend and trends, and Medicare Star Part D measures strongly desired.
• Experience working with Medicare and Commercial providers strongly preferred.
• PBM or Managed Care experience highly desired.
• Proficiency with Excel preferred.

Job Level: Non-Management Exempt

Workshift: 1st Shift (United States of America)

Job Family: MED > Licensed/Registered Pharmacist/Pharmacy Technician