Pharmacist-Consultant, Prior Authorization & DUR (Hybrid)

Blue Shield of CA; Lodi (CA); Hybrid; USD 140,000 - 190,000; Full time

Job summary

Blue Shield of California is seeking a Pharmacist-Consultant to join the Pharmacy Benefit Prior Authorization team, ensuring evidence-based decisions for outpatient pharmacy coverage. This role supports the P&T committee and reports to the DUR Pharmacist Manager.

Required are a PharmD, active CA RPh license, 2+ years of clinical pharmacy experience, and PA experience; familiarity with formulary policies is essential. Hybrid work model with occasional office attendance.

Qualifications

• Requires PharmD degree.
• Requires active, unrestricted California Pharmacist license (RPh).
• Requires at least 2 years of clinical pharmacy experience.
• Requires experience in a health plan, managed care, or academic setting.
• 1 year of prior authorization experience is required.
• Experience with formulary and medication policies is required.

Responsibilities

• Review authorization requests for outpatient pharmacy coverage.
• Support the PA team to implement evidence-based decisions.
• Contribute to formulary policies and medication safety initiatives.
• Report to the DUR Pharmacist Manager.

Skills

Communication skills

Pharmacology knowledge

Education

Doctor of Pharmacy (PharmD)

Job description

Blue Shield of California is seeking a Pharmacist-Consultant to join the Pharmacy Benefit Prior Authorization team, ensuring evidence-based decisions for outpatient pharmacy coverage. This role supports the P&T committee and reports to the DUR Pharmacist Manager.

Required are a PharmD, active CA RPh license, 2+ years of clinical pharmacy experience, and PA experience; familiarity with formulary policies is essential. Hybrid work model with occasional office attendance.