Utilization Management Pharmacist - Authorization & MTM

001 BlueCross and BlueShield of South Carolina; Columbia (SC); Hybrid; USD 110,000 - 130,000; Full time

Job summary

BlueCross BlueShield of South Carolina in Columbia, SC is seeking a pharmacist to perform utilization management reviews and educate providers on optimized medication outcomes. You will apply clinical guidelines to ensure safe, cost-effective therapy and collaborate with health professionals to improve patient care.

The role features a full-time office schedule with potential hybrid work after training and requires strong communication skills and a SC license.

Qualifications

• Bachelor's in a job related field.
• 3 years of clinical experience incl. 1 year UM/MTM reviews.
• Strong clinical pharmacy knowledge and communication skills.
• Active, unrestricted pharmacy licensure in SC.

Responsibilities

• Perform utilization management prior authorization reviews.
• Evaluate compliance with clinical criteria and guidelines.
• Inform prescribers of drug therapy problems and optimize regimens.
• Coordinate activities with care and disease management programs.

Skills

Clinical pharmacy knowledge

Communication skills

Discretion with confidential info

Customer service

Education

Bachelor's degree in a related field

Active SC pharmacist license

Tools

Microsoft Office

Job description

BlueCross BlueShield of South Carolina in Columbia, SC is seeking a pharmacist to perform utilization management reviews and educate providers on optimized medication outcomes. You will apply clinical guidelines to ensure safe, cost-effective therapy and collaborate with health professionals to improve patient care.

The role features a full-time office schedule with potential hybrid work after training and requires strong communication skills and a SC license.