Pharmacist Consultant – Prior Authorization & DUR (Hybrid)

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

Job summary

Blue Shield of California is seeking a Pharmacist-Consultant to join the Prior Authorization (PA) team. The role supports the Blue Shield of California Pharmacy and Therapeutics Committee (P&T) by ensuring evidence‑based clinical decisions are implemented to provide a high‑quality, cost‑effective outpatient pharmacy benefit.

The candidate will report to the DUR Pharmacist Manager, hold a PharmD with an active California RPh license, and bring at least two years of clinical pharmacy experience,

Qualifications

• Doctor of Pharmacy (PharmD) degree required.
• Active California Pharmacist (RPh) license required.
• Minimum 2 years of clinical pharmacy experience.
• Experience with health plans (managed care/government payer/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.

Skills

Clinical pharmacy

PA experience

Formulary knowledge

Communication skills

Therapeutic knowledge

Education

PharmD

Job description

Blue Shield of California is seeking a Pharmacist-Consultant to join the Prior Authorization (PA) team. The role supports the Blue Shield of California Pharmacy and Therapeutics Committee (P&T) by ensuring evidence‑based clinical decisions are implemented to provide a high‑quality, cost‑effective outpatient pharmacy benefit.

The candidate will report to the DUR Pharmacist Manager, hold a PharmD with an active California RPh license, and bring at least two years of clinical pharmacy experience,