Pharmacist, Consultant

Blue Shield of CA; Los Angeles (CA); Hybrid; USD 140,000 - 170,000; Full time

Job summary

Blue Shield of California is seeking a Pharmacist-Consultant to join the Prior Authorization (PA) team. You will review outpatient pharmacy requests and ensure evidence-based decisions align with formulary policies while supporting the P&T committee.

The role emphasizes clinical pharmacology expertise, effective communication, and collaboration with the DUR Pharmacist Manager in a hybrid virtual work model with periodic office visits as needed.

Qualifications

• Requires PharmD degree
• Requires active California RPh license
• Minimum 2 years of clinical pharmacy experience
• 1 year of prior authorization experience required
• Experience with formulary and medication policies
• Excellent oral and written communication skills
• Thorough knowledge of therapeutic use of medications

Responsibilities

• Review outpatient PA requests and ensure evidence-based decisions align with formulary policies.
• Support the Blue Shield of California Pharmacy and Therapeutics Committee (P&T).
• Collaborate with the DUR Pharmacist Manager to optimize drug utilization and patient outcomes

Skills

Communication skills

Clinical pharmacy

DUR experience

Education

PharmD degree

California RPh license

Job description

Your Role

The Prior Authorization (PA) team utilizes clinical knowledge to review authorization requests for coverage under the outpatient pharmacy benefit. The Pharmacist-Consultant will work as part of the pharmacy benefit Prior Authorization (PA) team to support the Blue Shield of California (BSC) Pharmacy and Therapeutics Committee (P&T) by ensuring that evidence based clinical decisions are implemented appropriately to provide a high-quality and cost-effective pharmacy benefit. The Pharmacist- Consultant (Drug Utilization Review Pharmacist) will report to the Drug Utilization Review (DUR) Pharmacist Manager.

Our leadership model is about developing great leaders at all levels and creating opportunities for our people to grow - personally, professionally, and financially. We are looking for leaders that are energized by creative and critical thinking, building and sustaining high-performing teams, getting results the right way, and fostering continuous learning.

Your Knowledge and Experience

• Requires a Doctor of Pharmacy (PharmD) degree
• Requires a currently active and unrestricted California Registered Pharmacist (RPh) license
• Requires at least 2 years of experience in clinical pharmacy
• Requires experience working at a health plan (managed care, government payer, or academic)
• 1 year of prior authorization experience required
• Experience working with formulary and medication policies required
• Excellent oral and written communication skills
• Thorough knowledge of therapeutic use of medications

Hybrid Virtual Work

This role allows employees to work virtually full-time, however employees will be expected to come to the office based on business need.