Professional Resident (Commercial/Medicare)

100 Horizon Healthcare Services, Inc; Newark (NJ); On-site; USD 45,000 - 60,000; Full time

Benefits offered by this job

Comprehensive health benefits

Retirement plans

Generous PTO

Tuition reimbursement

Wellness programs

Job summary

Horizon Blue Cross Blue Shield of New Jersey offers a one-year, structured post-graduate education and training program in our Commercial and Medicare lines of business. The role focuses on advanced drug therapy, pharmacoeconomics, and clinical services within a managed care setting.

The residency emphasizes clinical policy development, pharmacy case management, and outcomes research, with opportunities to attend national conferences and mentor Pharm.D. students.

Qualifications

• Requires a BS in pharmacy and a PharmD from an accredited college.
• Active Pharmacist License (unrestricted).
• Three letters of recommendation and CV included.

Responsibilities

• Clinical program incorporation into an online claims processor.
• Pharmacy case management and formulary development.
• Develop therapeutic class reviews and drug monographs.
• Address disease state management and clinical policies.
• Oversee prior authorization and drug utilization review.
• Support research projects and conference attendance.

Skills

Pharmacist license

Pharmacotherapy knowledge

Healthcare data systems

Education

Bachelor of Science in Pharmacy

Doctor of Pharmacy (PharmD)

Tools

Spreadsheet software

Database software

Project management software

Job description

Horizon Blue Cross Blue Shield of New Jersey empowers our members to achieve their best health. For over 90 years, we have been New Jersey’s health solutions leader driving innovations that improve health care quality, affordability, and member experience. Our members are our neighbors, our friends, and our families. It is this understanding that drives us to better serve and care for the 3.5 million people who place their trust in us. We pride ourselves on our best-in-class employees and strive to maintain an innovative and inclusive environment that allows them to thrive. When our employees bring their best and succeed, the Company succeeds.

About the Role

Horizon Blue Cross Blue Shield of New Jersey empowers our members to achieve their best health. For over 90 years, we have been New Jersey’s health solutions leader driving innovations that improve health care quality, affordability, and member experience. Our members are our neighbors, our friends, and our families. It is this understanding that drives us to better serve and care for the 3.5 million people who place their trust in us. We pride ourselves on our best-in-class employees and strive to maintain an innovative and inclusive environment that allows them to thrive. When our employees bring their best and succeed, the Company succeeds.

This is a one-year, structured post-graduate education and training program in our Commercial and Medicare Line of Business. The goal of the position is to provide advanced knowledge and skills regarding drug therapy and pharmaceutical services in a managed care environment.

What You'll Do

Responsibilities

• Clinical program incorporation into an on-line claims processor.
• Pharmacy case management.
• Development of therapeutic class reviews and drug monographs.
• Formulary development.
• Disease state management.
• Development of clinical policies.
• Prior authorization process.
• Drug utilization review.
• Outcomes research.
• Unique focus on government programs.
• Professional skills development and business administration.
• Research project.
• Attendance to at least one national conference.
• Assist with Pharm.D. student oversight.

What You Bring

Education/Experience

• Requires a bachelor's of science degree in pharmacy from an accredited college or university.
• Requires a Pharm D from an accredited college or university.
• Letter of Intent
• Curriculum Vitae
• Three Letters of Recommendation

Additional licensing, certifications, registrations:

• Active Unrestricted Pharmacist License
• Required
• Only If Making UM Decisions; NJ License Preferred.

Knowledge

• Requires knowledge of a spreadsheet software package.
• Requires knowledge of a database software package.
• Requires project management knowledge.
• Requires knowledge of internet clinical information databases.

Skills and Abilities

• Requires the ability to utilize a personal computer and applicable software.
• Requires the ability to think analytically.
• Requires excellent verbal and written communication skills.
• Requires strong organizational skills.
• Requires the ability to analyze medical literature, i.e. clinical trials

This is a pipeline requisition for the 2027 Pharmacy Residency Program, not currently an open position.

Why Horizon?

At Horizon, you’ll do meaningful work that directly improves lives—while being supported by a mission‑driven organization that values expertise, collaboration, and growth. We believe that when our people thrive, our communities do too.

Salary Range

$44,600 - $59,745

This compensation range is specific to the job level and takes into account the wide range of factors that are considered in making compensation decisions, including but not limited to: education, experience, licensure, certifications, geographic location, and internal equity. This range has been created in good faith based on information known to Horizon at the time of posting. Compensation decisions are dependent on the circumstances of each case.

Horizon also provides a comprehensive compensation and benefits package which includes:

• Comprehensive health benefits (Medical/Dental/Vision)
• Retirement Plans
• Generous PTO
• Incentive Plans
• Wellness Programs
• Paid Volunteer Time Off
• Tuition Reimbursement

Disclaimer: Horizon BCBSNJ employees must live in New Jersey, New York, Pennsylvania, Connecticut or Delaware.

This job summary has been designed to indicate the general nature and level of work performed by colleagues within this classification. It is not designed to contain or be interpreted as a comprehensive inventory of all duties, responsibilities, and qualifications required of colleagues assigned to this job.

Horizon Blue Cross Blue Shield of New Jersey is an Equal Opportunity/Affirmative Action employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, national origin, sexual orientation, gender identity or status as an individual with a disability and any other protected class as required by federal, state or local law.

Horizon will consider reasonable accommodation requests as part of the recruiting and hiring process.

About Us

We are the leading health insurer in New Jersey, trusted by generations of families and businesses. We are dedicated to enriching the lives and health of our members and the New Jersey communities we serve, because we live and work here too.

Our Mission

We empower our members to achieve their best health.

Our Vision

We are New Jersey’s health solutions leader driving innovations that improve health care quality, affordability and member experience in the markets we serve.