Clinical Pharmacist - Enterprise Cost & Reimbursement

Arkansas Blue Cross and Blue Shield; Little Rock (AR); On-site; USD 110,000 - 140,000; Full time

Job summary

Arkansas Blue Cross and Blue Shield is seeking a Clinical Pharmacist to work under Pharmacy Leadership, collaborating with medical directors and enterprise personnel. The role involves developing and supervising drug utilization and prior authorization programs, while supporting cost containment and enterprise initiatives.

The position requires a PharmD/BS in Pharmacy, an active license in the relevant states, and a minimum of three years of pharmacy practice experience, including managed care.

Qualifications

• Bachelor's degree in Pharmacy from an accredited college of pharmacy.
• Active, unrestricted pharmacy license in the state(s) where duties are performed.

Responsibilities

• Assists in development of and supervises the drug utilization and prior authorization review program.
• Contributes to Enterprise-wide undertakings and commitments.
• Develops, implements, and manages pharmacy cost containment strategies.
• Develops and implements pharmacy cost containment strategies tailored to enterprise, regions, and large accounts.
• Drafts medical criteria and supports enterprise prior authorization program.
• Prepares and presents reports on utilization and cost trends for various lines of business and regions.
• Provides leadership on pharmacy reimbursement, claims processing, and vendor selection.
• Serves as a corporate pharmacy resource to medical management, operations, and sales staffs.
• Serves as a liaison to pharmacists, professional organizations, committees, case management, and other providers.
• Uses clinical knowledge and independent critical thinking to make determinations on prior approvals.
• Works with vendors to ensure satisfactory service for members and providers.

Skills

Oral & Written Communication

Presentation

Organizational

Analytical

Problem-Solving

Decision-Making

Coaching Others

Conflict Resolution

Continuous Learning

Critical Thinking

Delegating Tasks

Employee Engagement

Evaluating Information

Interpersonal Communication

Interpersonal Relationships

Management Techniques

Monitor Processes

Oral Communications

Problem Sensitivity

Researching

Service Oriented

Time Management

Written Communication

Education

Bachelor's degree in Pharmacy

Job description

Arkansas Blue Cross and Blue Shield is seeking a Clinical Pharmacist to work under Pharmacy Leadership, collaborating with medical directors and enterprise personnel. The role involves developing and supervising drug utilization and prior authorization programs, while supporting cost containment and enterprise initiatives.

The position requires a PharmD/BS in Pharmacy, an active license in the relevant states, and a minimum of three years of pharmacy practice experience, including managed care.