Pharmacist-Consultant, PA & Formulary Strategy (Hybrid)

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

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.