Clinical Pharmacist - Data Analytics

Position Title Clinical Pharmacist - Data Analytics Anticipated End Date 2026-06-20 Location & Work Arrangement Hybrid 1: This role requires associates to be in-office 1-2 days per week for collaboration, while providing flexibility to support productivity and work‑life balance. Alternate locations may be considered if candidates reside within a commuting distance from an office. Roles & Responsibilities Researches and synthesizes detailed clinical data related to pharmaceuticals. Proactively identifies utilization management (UM) strategies that enhance the member experience while delivering positive financial outcomes. Analyzes prior authorization (PA) data and trends to develop recommendations, considering rebates, member impact, and operational efficiency. Monitors and evaluates UM performance to ensure effectiveness and alignment with organizational goals. Reports on PA performance metrics to support data‑driven decision‑making across teams. Forecasts the potential financial and administrative impact associated with UM initiatives. Tracks the financial impact of recently implemented UM. Builds and maintains 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 BA/BS in Pharmacy. Minimum of 2 years of managed care pharmacy (PBM) experience or residency in lieu of work experience; or an equivalent combination of education and experience. Registered pharmacist with a current unrestricted license in applicable state(s). Preferred Qualifications & Experience PharmD preferred. Managed care experience strongly preferred. Previous experience in pharmaceutical data analytics preferred. MBM and/or PBM experience also preferred. 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 U.S. military base, vessel, or any embassy located in or outside of the U.S., unless command‑sanctioned activities are justified. For URAC accredited areas, associates are expected to have strong oral, written, interpersonal communication skills, problem‑solving skills, facilitation skills, and analytical skills. Salary & Benefits Salary range: $119,360 – $205,896, depending on geographic location, experience, education, and skill level. Comprehensive benefits package, incentive and recognition programs, equity stock purchase, and 401(k) contribution. Job Level & Family Job Level: Non‑Management Exempt Job Family: MED > Licensed/Registered Pharmacist/Pharmacy Technician Equal Employment Opportunity Statement Elevance Health is an Equal Employment Opportunity employer, and all qualified applicants will receive consideration for employment without regard to age, citizenship status, color, creed, disability, ethnicity, gender (including gender identity and gender expression), marital status, national origin, race, religion, sex, sexual orientation, veteran status or any other status or condition protected by applicable federal, state, or local laws. #J-18808-Ljbffr The Elevance Health Companies, Inc.