Anthem, Inc. Pharmacist Clinical/STARs in Reston, Virginia
SHIFT: 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.
Summary: The Pharmacist Clinical is responsible for providing clinical pharmacy support to Medicare and Commercial providers. Duties and responsibilities will be focused on improving quality(STAR and HEDIS) and cost measures through close collaboration with providers engaged in value based care arrangements. You will be responsible for influencing providers to change prescribing practices to improve member health and reduce the total cost of care. To be successful in this role, you’ll need to have excel experience and passionate about building relationships to improve member health. We are looking for candidates with PBM or Managed Care experience; retail pharmacy experience does not apply.
Primary duties may include, but are not limited to:
Support network physicians by analyzing organizational and practice-level reports and identifying opportunities to:
Improve pharmacy quality (STAR, HEDIS, etc)
Reduce pharmacy cost
During practice-level discussions, act as a subject matter expert in pharmacy-related clinical measures for value-based care agreements
Attend external provider meetings to communicate practice-level pharmacy goals and opportunities for reaching goals
Educate internal matrix provider partners about pharmacy programs and goals
Field questions from providers related to Pharmacy programs (benefits, reporting tools, CMS, formulary, etc.)
Participate in development and testing of pharmacy provider tools with the lens of a clinical user
Close feedback loop between Anthem Pharmacy and Providers
Stay up to date with STAR & HEDIS measures
Provide education to the external network providers as requested/needed in support of Clinical pharmacy measures
Requires a registered pharmacist; 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
Must possess an active unrestricted state license to practice pharmacy as a Registered Pharmacist (RPh)
Requires strong oral, written and interpersonal communication skills, problem-solving skills, facilitation skills, and analytical skills
Experience influencing providers prescribing practices
Managed care pharmacy experience outside of solely retail strongly preferred.
Prior experience with developing programs impacting providers strongly preferred
Position will be office based with occasional travel required (approx. 10-20%)
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.