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Location: , MO
Job Family: Medical
Req #: PS49038-Missouri
Date Posted: May 8, 2021
DescriptionSHIFT: Day Job
Your Talent. Our Vision. At Anthem, Inc., it’s a powerful combination, and the foundation upon which we’re creating greater access to care for our members, greater value for our customers, and greater health for our communities. Join us and together we will drive the future of health care.
This is an exceptional opportunity to do innovative work that means more to you and those we serve at one of America's leading health care companies and a Fortune Top 50 Company.
Pharmacist Program Manager
Our Pharmacist Program Manager is responsible for managing the intake of formulary and utilization management change requests for the Medicare line of business and ensuring those changes are implemented timely and accurately. This position is also responsible for overseeing daily business operations.
Primary duties may include, but are not limited to:
• Intake of formulary and utilization management change requests from Medicare programs, ensuring those changes are implemented timely and accurately
• Translating client intent into clinical coding requirements
• Interfaces with multiple teams to ensure smooth implementation of clinical requirements
• Analyzing detailed clinical data related to formulary, utilization management, and pharmacy claims adjudication
• Serving as a clinical resource on the team
• Daily workflow monitoring and prioritization
• Collaborating on multiple cross-functional projects, meeting deadlines
• Mentoring/leadership of non-clinical associates
• Must be a registered pharmacist, active, current license (without restrictions) to practice pharmacy in any state.
• Minimum 2 years of managed care pharmacy (PBM) experience; or any combination of education and experience, which would provide an equivalent background required.
• At least 3-5 years experience working with pharmacy benefit management operations, or equivalent background preferred.
• Experience working with government programs (Medicare and/or Medicaid) strongly preferred.
• PharmD preferred.
• Experience with formulary design and claims operations, development, and/or implementation of utilization management edits or criteria preferred
• Proficiency in MS Office Suite
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.
Anthem, Inc. is ranked as one of America’s Most Admired Companies among health insurers by Fortune magazine and has been named a 2019 Best Employers for Diversity by Forbes. To learn more about our company and apply, please visit us at careers.antheminc.com. An Equal Opportunity Employer/Disability/Veteran. Anthem promotes the delivery of services in a culturally competent manner and considers cultural competency when evaluating applicants for all Anthem positions.
Please be advised that Anthem only accepts resumes from agencies that have a signed agreement with Anthem. Accordingly, Anthem is not obligated to pay referral fees to any agency that is not a party to an agreement with Anthem. Thus, any unsolicited resumes, including those submitted to hiring managers, are deemed to be the property of Anthem.