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Pharmacist Clinical (Ambulatory Care experience required): (Cerritos-CA, Long Beach-CA, Lawndale-CA) - PS27755

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Medical
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PS27755 Requisition #
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 benefits companies and a Fortune Top 50 Company.


Pharmacist Clinical (Ambulatory Care experience required) - PS27755
Location(s): Cerritos-CA, Long Beach-CA, Lawndale-CA

The Ambulatory Care Clinical Pharmacist is a licensed pharmacist with a Doctor of Pharmacy Degree and American Society of Health Systems Pharmacist accredited residency or is Board Certified in ambulatory care pharmacy. In this position the Pharmacist performs a variety of job functions in an ambulatory care clinic setting (CareMore Care Centers), telephonic outreach and virtual care center, relating to the direct care of patients.

Primary duties may include, but are not limited to:
  • Researches and synthesizes detailed clinical data related to pharmaceuticals.
  • May review and approve or deny coverage for pharmaceuticals (as permitted by state/federal law or state/federal program contracts) based on medical necessity criteria, and coordinates with Anthem or health plan medical directors as needed. 
  • Serves as a clinical resource to other pharmacists on areas such as prospective, inpatient and retrospective DURs and provides dosage conversion and clinical support for therapeutic interventions. 
  • Prepares information for network physicians. 
  • Work collaboratively with an interdisciplinary team to provide pharmaceutical care to members by conducting Comprehensive Medication Reviews (CMR) for polypharmacy, drug allergies, clinical effectiveness, cost effective drug selection, dose optimization, contraindications, adverse effects, potential drug interactions, therapeutic outcomes and adherence. 
  • Provide direct care to patients in clinic or virtual care to initiate and prescribe new drug therapy, adjust, monitor or discontinue existing therapy under approved protocol for selected disease states including anticoagulation clinic, psych, diabetes, CHF, COPD, hypertension, and hyperlipidemia. 
  • Review medication regimen with patient, in person or telephonically, through the MTM program 
  • Participate in Medication Reconciliation for HEDIS measure 
  • Participate in development of educational lectures and materials for CareMore clinical staff and patients. 
  • Answer inquiries from physicians and nurse practitioners regarding clinical appropriateness, current guidelines and new drugs. 
  • Answer inquiries from sales team, and members related to formulary and prescription benefit. 
  • Support pharmacy initiatives to improve quality outcomes and lower medication cost to members and organization.
  • Understand and present reports on drug utilization and cost to providers and regional management. 
  • Adhere to all Medicare part D and Part B policy and procedures. 
  • Some local travel required. 
  • Minimal supervisory duties. 

  • Minimum 2 years or more of ambulatory care pharmacy experience including clinical practice (direct patient care) primary care experience OR American Society of Health Systems Pharmacists accredited residency in lieu of work experience required. 
  • Board certified in BCACP, BCPS or BCGP strongly preferred. 
  • Degree in Doctor of Pharmacy (PharmD) strongly preferred. 
  • Requires a Bachelor’s degree in Pharmacy; minimum 2 years of managed care pharmacy (PBM) experience or residency in lieu of work experience; or any combination of education and experience, which would provide an equivalent background. 
  • Requires a registered pharmacist; must possess an active unrestricted CA state license to practice pharmacy as a Registered Pharmacist (RPh). 
  • Spanish speaking strongly preferred. 
  • Unless expressly allowed by state or federal law, or regulation, must be located in a state or territory of the United States when conducting utilization review or an appeals consideration and cannot be located on a US military base, vessel or any embassy located in or outside of the US, unless they are command-sanctioned activities. 
  • For URAC accredited areas the following applies: Requires strong oral, written and interpersonal communication skills, problem-solving skills, facilitation skills, and analytical skills. 


Anthem, Inc. is ranked as one of America’s Most Admired Companies among health insurers by Fortune magazine and is a 2018 DiversityInc magazine Top 50 Company for Diversity. To learn more about our company and apply, please visit us at careers.antheminc.com. An Equal Opportunity Employer/Disability/Veteran.

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