Manager Pharmacy Clinical Operations - CarelonRx - Mail-Order Call Center
Elevance Health

Job Info

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Manager Pharmacy Clinical Operations - CarelonRx - Mail-Order Call Center

Location: The ideal candidate will live within 50 miles of our Grand Prairie, TX. Pulse Point location and will begin full-time in the office through the training process and will move to a hybrid work model (1-2 days per week in the office).

CarelonRx Pharmacy is now part of CarelonRx (formerly IngenioRx), a proud member of the Elevance Health family of companies. The CarelonRx Home Delivery Pharmacy will deliver a digital-first pharmacy experience that is convenient, simpler to use, and more affordable for our patients and payors. Our Pharmacy model focuses on whole-person care, providing the best member experience to drive adherence, affordability, and improved overall health outcomes by putting the patient first.

The Manager of Pharmacy Clinical Operations is responsible for developing and implementing clinical pharmacy programs to promote quality and cost-effective drug utilization.

How you will make an impact:

• Assists in the development of new clinical products.
• Oversees the Prior Authorization Center.
• Implements new prior authorization program.
• Manages clinical pharmacy operations and staff to ensure clients' objectives and deliverables are met.
• Oversees departmental processes, policies and procedures, training, and communication.
• Reports and analyzes prior authorization program trends.
• Ensures achievement of department goals and objectives.
• Hires, trains, coaches, counsels, and evaluates the performance of direct reports.

Minimum Requirements:

• Requires BA/BS in Pharmacy or a PharmD and minimum of 5 years of experience in managed care, authorization, or related pharmacy experience; or any combination of education and experience, which would provide an equivalent background.
• Must possess an active, current, and valid unrestricted state license (Rph) to practice pharmacy within the scope of practice in a state or territory of the United States. Unless expressly allowed by state or federal law, or regulation, must be located in a state or territory of the United States when conducting a 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 United States.

Preferred Skills, Qualifications and Experiences:

• Holds unrestricted Pharmacist state licensure in at least 1-2 states with willingness to obtain additional licenses as needed
• Experience in central fill or mail-order pharmacy operations
• Call center experience highly desired
• Bilingual, Spanish desired

Please be advised that Elevance Health only accepts resumes for compensation from agencies that have a signed agreement with Elevance Health. Any unsolicited resumes, including those submitted to hiring managers, are deemed to be the property of Elevance Health.

Who We Are

Elevance Health is a health company dedicated to improving lives and communities - and making healthcare simpler. We are a Fortune 25 company with a longstanding history in the healthcare industry, looking for leaders at all levels of the organization who are passionate about making an impact on our members and the communities we serve.

How We Work

At Elevance Health, we are creating a culture that is designed to advance our strategy but will also lead to personal and professional growth for our associates. Our values and behaviors are the root of our culture. They are how we achieve our strategy, power our business outcomes and drive our shared success - for our consumers, our associates, our communities and our business.

We offer a range of market-competitive total rewards that include merit increases, paid holidays, Paid Time Off, and incentive bonus programs (unless covered by a collective bargaining agreement), medical, dental, vision, short and long term disability benefits, 401(k) +match, stock purchase plan, life insurance, wellness programs and financial education resources, to name a few.

Elevance Health operates in a Hybrid Workforce Strategy. Unless specified as primarily virtual by the hiring manager, associates are required to work at an Elevance Health location at least once per week, and potentially several times per week. Specific requirements and expectations for time onsite will be discussed as part of the hiring process. Candidates must reside within 50 miles or 1-hour commute each way of a relevant Elevance Health location.

The health of our associates and communities is a top priority for Elevance Health. We require all new candidates in certain patient/member-facing roles to become vaccinated against COVID-19. If you are not vaccinated, your offer will be rescinded unless you provide an acceptable explanation. Elevance Health will also follow all relevant federal, state and local laws.

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, genetic information, 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. Applicants who require accommodation to participate in the job application process may contact elevancehealthjobssupport@elevancehealth.com for assistance.

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