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Posted: 10/16/2026Clinical Pharmacist – Prior Authorization
Elevance HealthCore Competencies
Role fitCore Competencies
Use this summary to align your resume positioning with the role.
Demonstrates expertise in managed care pharmacy, including pharmaceutical selection, clinical program support, and drug coverage evaluation. Strong communication and analytical skills are essential for effective collaboration with healthcare stakeholders and presenting clinical data.
Highest-signal resume keywords
Licensed PharmacistManaged Care Pharmacy ExperiencePharmD PreferredClinical Data AnalysisCommunication Skills
About the role
Key responsibilities & impact- Manage the selection and utilization of pharmaceuticals
- Support clinical programs such as DUR, DIS and formulary management
- Research and synthesize detailed clinical data related to pharmaceuticals
- Prepare and present therapeutic class reviews and drug monograph information to the Pharmacy and Therapeutics Committee
- Review and approve or deny pharmaceutical coverage, as permitted by law and applicable contracts, based on medical necessity criteria
- Coordinate with internal stakeholders and health plan medical directors
- Serve as a clinical resource to pharmacists on prospective, inpatient and retrospective DURs
- Provide dosage conversion and clinical support for therapeutic interventions
- Prepare information for network physicians
Requirements
What you’ll need- Licensed in North Carolina or Kansas
- BA/BS in Pharmacy
- Minimum of 2 years of managed care pharmacy (PBM) experience or residency in lieu of work experience
- Registered pharmacist
- Active unrestricted state license to practice pharmacy as a Registered Pharmacist (RPh)
- Strong oral, written and interpersonal communication skills
- Problem-solving skills
- Facilitation skills
- Analytical skills
- PharmD very strongly preferred
- For associates working within Puerto Rico who are member or patient facing either in a clinical setting or in the Best Transportation unit: current PR health certificate and current PR Law 300 certificate are required
Benefits
Comp & perks- Merit increases
- Paid holidays
- Paid Time Off
- Incentive bonus programs
- Medical benefits
- Dental benefits
- Vision benefits
- Short-term disability benefits
- Long-term disability benefits
- 401(k) with company match
- Stock purchase plan
- Life insurance
- Wellness programs
- Financial education resources
- Virtual full-time work with flexibility and autonomy
- Required in-person training sessions
- Professional growth opportunities
ATS Keywords
✓ Tailor your resumeApplicant Tracking System Keywords
Tip: use these terms in your resume and cover letter to boost ATS matches.
Hard Skills
Pharmaceutical SelectionFormulary ManagementClinical Program SupportDrug Monograph PreparationDosage Conversion
Soft Skills
Problem-Solving SkillsFacilitation SkillsInterpersonal Communication Skills
Certifications & Qualifications
Active Unrestricted State LicenseCurrent PR Health CertificateCurrent PR Law 300 Certificate
Industry Keywords
Pharmacy and Therapeutics CommitteeDURDISPharmaceutical CoverageMedical Necessity Criteria