Staff VP Specialty Pharmacy Clinical Operations

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CarelonRx a proud member of the Elevance Health family of companies leverages the power of new technologies and a strong clinical-first lens to deliver member-centered lasting pharmacy care.

Staff VP Specialty Pharmacy Clinical Operations

Location:May be located in any Elevance Health PulsePoint office preferably in Indianapolis IN; Atlanta GA; Mason OH; Richmond VA; Norfolk VA; or Woodland Hills CA.

This role requires associates to be in-office at least three 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 locations will not be considered for employment unless an accommodation is granted as required by law.

Summary

The Staff VP Specialty Pharmacy Clinical Operations will oversee the Clinical COE of BioPlus Specialty Pharmacy including the recently integrated Kroger Specialty Pharmacy. Key objectives of this role include improving patient care outcomes enhancing service delivery and ensuring regulatory compliance. Functions that this role oversees include case management prescription verification care management nursing and clinical program development.

Position Responsibilities

• Manage the specialty pharmacy management strategy across both pharmacy and medical for the enterprise.

• Participate in clinical program/policy development.

• Manage Strategic Business Unit drug trend and drug spend per member per month (PMPM).

• Oversee the development and maintenance of member/provider communications associated with safety and quality of care programs.

• Establish drug benefit design strategies to ensure affordability generic utilization and medication adherence in compliance with contract language and state/federal regulations.

• Oversee a cross-functional team of clinical analytic and pharmacy subject matter experts.

• Provide regulatory/legislative expertise on pharmacy issues.

• Provide support to grow and sustain membership with subject matter expertise in response to RFPs and participation in client meetings as requested.

• Interface with Health Plan stakeholders Pharmacy Benefits Management (PBM) leadership and senior management.

• Hire train coach counsel and evaluate the performance of direct reports.

Position Requirements

BA/BS and pharmacist license in applicable states with a minimum of eight years of experience in a PBM clinical pharmacy which includes a minimum of three years of management experience leading clinical professionals; or any combination of education and experience which would provide an equivalent background.

Preferred Skills Capabilities and Experiences

• Proven track record of managing clinical operations.

• Strong leadership and managerial skills with experience leading large diverse teams.

• Ability to inspire and motivate teams towards achieving key organizational objectives.

• Understanding of clinical program development case management prescription verification and patient care processes.

• Experience in care management within a pharmacy setting.

• Thorough understanding of industry regulations and compliance requirements including those relevant to specialty pharmacy and healthcare services.

• Demonstrated ability to develop and implement strategies that improve patient care outcomes and enhance service delivery.

• Excellent communication and interpersonal skills with the ability to collaborate effectively with internal and external stakeholders.

• Strong analytical and problem-solving skills to address operational challenges and optimize processes.

• Proven capability in driving continuous improvement initiatives and implementing innovative solutions in clinical operations.

Corporate Title:Staff VP Clinical & Spec Pharm

For candidates working in person or virtually in the below location(s) the salary* range for this specific position is $178400.00 to $321120.00.

Locations: California Colorado Illinois Minnesota Nevada New Jersey New York Washington State

In addition to your salary Elevance Health offers benefits such as a comprehensive benefits package incentive and recognition programs equity stock purchase and 401k contribution (all benefits are subject to eligibility requirements). The salary offered for this specific position is based on a number of legitimate non-discriminatory factors set by the Company. The Company is fully committed to ensuring equal pay opportunities for equal work regardless of gender race or any other category protected by federal state and local pay equity laws.

* The salary range is the range Elevance Health in good faith believes is the range of possible compensation for this role at the time of this posting. This range may be modified in the future and actual compensation may vary from posting based on geographic location work experience education and/or skill level. Even within the range the actual compensation will vary depending on the above factors as well as market/business considerations. No amount is considered to be wages or compensation until such amount is earned vested and determinable under the terms and conditions of the applicable policies and plans. The amount and availability of any bonus commission benefits or any other form of compensation and benefits that are allocable to a particular employee remains in the Companys sole discretion unless and until paid and may be modified at the Companys sole discretion consistent with the law.

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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.

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 and Influenza. 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 for assistance. Qualified applicants with arrest or conviction records will be considered for employment in accordance with all federal state and local laws including but not limited to the Los Angeles County Fair Chance Ordinance and the California Fair Chance Act.