Remote Clinical Pharmacist - Cost and Utilization Leader

Arkansas Blue Cross Blue Shield; United States; Remote; USD 90,000 - 120,000; Full time

Job summary

Arkansas Blue Cross and Blue Shield seeks a Clinical Pharmacist to report to Pharmacy Leadership and collaborate with medical directors and enterprise personnel. The role emphasizes development of drug utilization and prior authorization programs, cost containment strategies, and enterprise-wide pharmacy initiatives.

Requirements include a Doctoral-level license in pharmacy in applicable states, a bachelor’s degree in pharmacy, and a minimum of three years’ practice with preferred managed care

Qualifications

• Bachelor’s degree in Pharmacy from an accredited college of pharmacy.
• Holds an active and current, unrestricted license in pharmacy in the state(s) where job duties are performed required.
• Minimum three (3) years’ pharmacy practice experience.
• Minimum three (3) years’ experience in managed pharmacy care and drug utilization review preferred.

Responsibilities

• Assists in development of and supervises the drug utilization and prior authorization review program.
• Contributes to and supports Enterprise-wide undertakings and commitments.
• Develops, implementks, and manages pharmacy cost containment strategies.
• Develops and implements pharmacy cost containment strategies tailored to the specific situations and patterns of the enterprise, specific regions, and large accounts.
• Drafts medical criteria and performs other activities in support of the enterprise prior authorization program.
• Prepares and presents reports, data and analyses on the utilization and cost trends for enterprise lines of business, specific regions, and large accounts.
• Provides leadership and advice on developing and implementing pharmacy reimbursement, claims processing policies and procedures, and pharmacy vendor selection.
• Serves as a corporate pharmacy resource to medical management, operations, and sales staffs on pharmacy issues.
• Serves as a liaison to individual pharmacists, professional pharmacy organizations, internal committees, case management, medical management, and other providers on pharmacy issues.
• Uses clinical knowledge and independent critical thinking skills towards interpreting criteria, policies, and procedures to make determinations on prior approval reviews and retrospective reviews.
• Works with the clinical and operations staff of all vendors of pharmacy programs to ensure that members and providers are receiving a satisfactory-level of service

Skills

Coaching Others

Conflict Resolution

Continuous Learning

Critical Thinking

Delegating Tasks

Employee Engagement Strategies

Evaluating Information

Interpersonal Communication

Interpersonal Relationships

Management Techniques

Monitor Processes

Oral Communications

Problem Sensitivity

Researching

Service Oriented

Time Management

Written Communication

Education

Bachelor’s degree in Pharmacy

Job description

Arkansas Blue Cross and Blue Shield seeks a Clinical Pharmacist to report to Pharmacy Leadership and collaborate with medical directors and enterprise personnel. The role emphasizes development of drug utilization and prior authorization programs, cost containment strategies, and enterprise-wide pharmacy initiatives.

Requirements include a Doctoral-level license in pharmacy in applicable states, a bachelor’s degree in pharmacy, and a minimum of three years’ practice with preferred managed care