Clinical Pharmacist:
Evolent Health

1575659689
Evolent Health
Raleigh North Carolina
Biotech
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Description
**Your Future Evolves Here**

Evolent Health has a bold mission to change the health of the nation by changing the way health care is delivered. Evolenteers make a difference wherever they are, whether it is at a medical center, in the office, or while working from home across 48 states. We empower you to work from where you work best, which makes juggling careers, families, and social lives so much easier. Through our recognition programs, we also highlight employees who live our values, give back to our communities each year, and are champions for bringing their whole selves to work each day. If you're looking for a place where your work can be personally and professionally rewarding, don't just join a company with a mission. Join a mission with a company behind it.

**Why We're Worth the Application:**

+ We continue to grow year over year.

+ Recognized as a leader in driving important diversity, equity, and inclusion (DE&I) efforts () .

+ Achieved a 100% score two years in a row on the Human Rights Campaign's Corporate Equality Index making us a best place to work for LGBTQ+ equality.

+ Named to Parity.org's 2020 list of the best companies for women to advance () .

+ Continued to prioritize the employee experience and achieved an 87% overall engagement score on our last employee survey.

+ Published an annual DE&I report () to share our progress on how we're building an equitable workplace.

**What You'll Be Doing:**

**The Role**

Evolent Health is looking for a licensed Clinical Pharmacist to be a key member of the Pharmacy Services team. This individual will play a critical role in executing Evolent Health's mission by serving as a Utilization Management Pharmacist. The Pharmacy team has a blend of responsibilities pertaining to health plan management of the pharmacy benefit across multiple lines of business (Commercial, Exchange, Medicare, and Medicaid). The Clinical Pharmacist - Utilization Management role will support all lines of business via their contribution to the clinical aspects of the Utilization Management (UM) review process. We are looking for team members that possess high energy, a strong work ethic, integrity, who are kind and empathetic, have a sense of humor, and who enjoy working for a collaborative, team-oriented system.

**Responsibilities**

**Pharmacy Utilization Management**

+ Support all lines of business via reviewing utilization management requests for drug coverage under both the pharmacy and medical benefits

+ Evaluate requests for both clinical appropriateness and cost effectiveness

+ Coordinate with Pharmacy technicians, Pharmacists, and Medical Directors on UM activities

+ Ensure cases are reviewed in accordance with State and/or Federal guidelines including turnaround time requirements

+ As needed, discuss clinical strategy and decision rationale with prescribers

+ Participate in the quality review and inter-rater reliability processes

**Clinical Operations Support**

+ Supports P&T process including the development of therapeutic class/drug monographs as needed

+ Research and develop therapy-specific clinical policies and utilization management programs such as Prior Authorization, Step Therapy, Quantity Limit, and/or Coverage Determination programs

+ Support Clinical Operations line of business leaders as needed

+ Support utilization management team projects as needed

**Required Qualifications**

+ Pharmacy degree; either BS Pharmacy or PharmD

+ 1 year experience coordinating medication selection with prescribers and their care teams

+ Pharmacist license in good standing in state of residence. Willingness to achieve and maintain licensure in multiple states

+ Willing to work evenings and weekends

**Preferred Qualifications**

+ Experience reviewing and developing medical drug management criteria (i.e., JCode management)

+ +1 year of managed care and/or prior authorization experience

+ +2 years Medicare Advantage health plan pharmacy experience

+ Excellent written and verbal communication skills

**Skills and Behavioral Attributes**

+ Ability to make independent clinical decisions

+ Committed to team-oriented work environment

+ Exceptional interpersonal, presentation, oral and written communication skills

+ Strong work ethic built on a foundation of proactivity

+ Committed to the practice of inquiry and listening

+ Navigate ambiguity with structured problem-solving and decision-making

+ Analytic with the ability to transform data & trends into actionable insight

**Technical Requirements:**

Currently, Evolent employees work remotely temporarily due to COVID-19. As such, we require that all employees have the following technical capability at their home: High speed internet over 10 Mbps and, specifically for all call center employees, the ability to plug in directly to the home internet router. These at-home technical requirements are subject to change with any scheduled re-opening of our office locations.

Evolent Health is committed to the safety and wellbeing of all its employees, partners and patients and complies with all applicable local, state, and federal law regarding COVID health and vaccination requirements. Evolent expects all employees to also comply. We currently require all employees who may voluntarily return to our Evolent offices to be vaccinated and invite all employees regardless of vaccination status to remain working from home. Certain jobs require face-to-face interaction with our providers and patients in client facilities or homes. Employees working in such roles will be required to meet our vaccine requirements without exception or exemption.

**Evolent Health is an equal opportunity employer and considers all qualified applicants equally without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, veteran status, or disability status.**

Compensation Range: The minimum salary for this position is $, plus benefits. Salaries are determined by the skill set required for the position and commensurate with experience and may vary above and below the stated amounts.