Pharmacist, Consultant

Blue Shield of CA; Springfield Meadows (CA); Hybrid; USD 140,000 - 180,000; Full time

Job summary

Blue Shield of California is seeking a Pharmacist-Consultant to review outpatient pharmacy authorization requests and support the P&T committee with evidence-based decisions. This role will report to the DUR Pharmacist Manager and operate within the PA team.

The position requires a PharmD, active CA RPh license, and 2+ years of clinical pharmacy experience, including 1 year in prior authorization and formulary policy work. Hybrid work with optional in-office collaboration.

Qualifications

• Doctor of Pharmacy (PharmD) degree required.
• Active California RPh license required.
• Minimum 2 years of clinical pharmacy experience.
• Experience in health plans (managed care, government payer, or academic).
• 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 authorization requests for coverage under the outpatient pharmacy benefit as part of the PA team.
• Support Blue Shield of California's Pharmacy and Therapeutics Committee by implementing evidence-based decisions.
• Report to the DUR Pharmacist Manager as part of the Drug Utilization Review team.
• Hybrid virtual work model with in-office attendance based on business needs.

Skills

Clinical pharmacy

PA (Prior Authorization) experience

Formulary knowledge

Communication skills

Therapeutic use of medications

Pharmacist license

Health plan experience

Education

Doctor of Pharmacy (PharmD)

California RPh license

Tools

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.