Managed Care Pharmacy Resident
Managed Care Pharmacy Resident
Location: 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. Alternate locations may be considered.
Please note that per our policy on hybrid/virtual work, candidates not within a reasonable commuting distance from the posting location(s) will not be considered for employment, unless an accommodation is granted as required by law.
Be Part of an Extraordinary Team
A proud member of the Elevance Health family of companies, CarelonRx (formerly IngenioRx) leverages the power of new technologies and a strong, clinical-first lens, to deliver member-centered, lasting pharmacy care.
The Managed Care Pharmacy Resident will be responsible for various operational or clinical aspects of the CarelonRx pharmacy program, including Prior Authorizations, Medication Therapy Management (MTM), Lock-in, and Drug Utilization Review (DUR) programs.
How you will make an impact:
- Complete work related to the Pharmacy and Therapeutics Committee including therapeutic class reviews, policy review, drug monographs, and formulary recommendations.
- Develop strategies to drive formulary utilization and optimization.
- Collaborate with account management teams to analyze drug usage data, support initiatives to optimize pharmacy spend and improve member and client outcomes.
- Complete a year-long project targeted at improving member care through proper medication management.
- Perform weekly clinical prior authorizations and coverage determinations for Medicaid and Medicare.
- Participate in the pharmaceutical care management process through reviewing member profiles, recommending members for lock-in, case management or disease management.
- Respond to and resolve issues related to member/provider complaints, claims processing issues and appeals.
Minimum requirements:
- PharmD from an accredited school of pharmacy by start date.
- Registered Pharmacist; must possess an active, unrestricted state license to practice pharmacy as an RPh or able to obtain one within 90 days of start date
- Authorized to work in the U.S. without future visa sponsorship requirements
- Completion of application which also includes letter of intent and curriculum vitae (CV)
- Three letters of recommendation and official pharmacy school transcripts emailed directly to PharmacyResidency@ElevanceHealth.com
Preferred Skills, Capabilities and Experiences:
- Managed care experience; or any combination of education and experience, which would provide an equivalent background
- Familiarity with Microsoft Office Products (Word, Excel, PowerPoint, etc.)
- Excellent communication skills, both written and oral
- Excellent problem-solving, analytical and organizational skills
- Excellent public speaking and presentation skills
- Strong interest in managed care pharmacy
Application Process:
- Application, letter of intent and CV due December 15, 2025, at 11:59 pm EST.
- Three letters of recommendation and official pharmacy school transcripts emailed to PharmacyResidency@ElevanceHealth.com by December 15, 2025, at 11:59 pm EST.
- Preliminary interviews first week of January 2026
- Full day interviews about the third week of January 2026