Pharmacist, Consultant

Blue Shield of CA; Redding (CA); Hybrid; USD 120,000 - 150,000; Full time

Job summary

Blue Shield of California seeks a Pharmacist-Consultant to join the Prior Authorization team to support evidence-based decisions for the outpatient pharmacy benefit. You will work to ensure high-quality, cost-effective pharmacotherapy guidance within the Pharmacy and Therapeutics Committee framework.

The role requires a PharmD, an active California RPh license, and at least 2 years of clinical pharmacy experience, including prior authorization experience and formulary knowledge.

Qualifications

• Requires a Doctor of Pharmacy (PharmD) degree.
• Requires active 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.

Skills

Clinical pharmacy

Prior authorization

Formulary knowledge

Communication skills

Therapeutic knowledge

Health plan experience

RPh license

Education

PharmD

Job description

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.