Pharmacist, Consultant
3 weeks ago
Your Role The Pharmacy Services Drug Utilization Management team provides efficient and accurate responses to external customer (physicians, office staff, pharmacy providers, members and brokers) and internal team members for all outpatient medical benefit inquires. The Pharmacist Consultant will report to the Manager of Medical Benefit Drug Utilization. In this role you will support the Blue Shield of California Pharmacy and Therapeutics (P&T) Committee process and supportthe clinical components of the Pharmacy Services Drug Utilization Program by ensuring that evidence based clinical decisions of the Blue Shield of California Pharmacy and Therapeutics Committee are implemented operationally in order to support safe, efficacious, and cost-effective prescribing of medications provided under the medical benefit. Your Work In this role, you will: Provide pharmacotherapy expertise for Blue Shield’s pharmacy program by supporting: Pharmacy and Therapeutics Committee, drug formulary, drug prior authorization and utilization review programs, health plan benefit design, member/provider communications related to medication use, and the pharmacy student/residency programs Operate in compliance with all regulatory and accreditation requirements, and corporate policies and procedures regarding to support access to safe, efficacious, and medically necessary medications Assist in preparing materials for audits and reports; completes projects as assigned Support the operational and clinical implementation of medication policies for drugs provided under the medical benefit, for both Commercial, Medicare, and Medi-Cal lines of business Support the peer to peer process and facilitate provider discussion regarding prior authorization denials. Provide pharmacist support for the drug prior authorization program by providing clinical expertise to Prior Authorization technician team to ensure review of prior authorization requests within regulatory required time frames Provide clinical and operational expertise in post service requests, completed within regulatory required time frames Ensure compliance with various regulatory and quality accreditation requirements around drug utilization management in order to support safe, efficacious, and cost-effective prescribing Serve as an educational resource to internal and external constituents regarding the Blue Shield drug formulary, medication policies and appropriate drug use Your Knowledge and Experience Requires a Doctor of Pharmacy (PharmD) degree Requires a currently active and unrestricted California Registered Pharmacist (RPh) license Requires at least 2 years of experience in clinical pharmacy Prior experience in managed care/PBM is preferred Requires working at least one weekend per month and company holidays as needed to ensure regulatory compliance with prior authorization turn around times Requires thorough knowledge of therapeutic use of medications Requires excellent oral and written communication skills Pay Range: The pay range for this role is: $ 118800.00 to $ 178200.00 for California. Note: Please note that this range represents the pay range for this and many other positions at Blue Shield that fall into this pay grade. Blue Shield salaries are based on a variety of factors, including the candidate's experience, location (California, Bay area, or outside California), and current employee salaries for similar roles. #LI-SS8
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Pharmacist, Consultant
2 weeks ago
Rancho Cordova, United States Blue Shield of California Full timeYour Role The Pharmacy Services Drug Utilization Management team provides efficient and accurate responses to external customer (physicians, office staff, pharmacy providers, members and brokers) and internal team members for all outpatient medical benefit inquires. The Pharmacist Consultant will report to the Manager of Medical Benefit Drug Utilization. In...
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Pharmacist, Consultant
3 weeks ago
Rancho Cordova, United States Blue Shield of California Full timeYour Role The Pharmacy Services Drug Utilization Management team provides efficient and accurate responses to external customer (physicians, office staff, pharmacy providers, members and brokers) and internal team members for all outpatient medical benefit inquires. The Pharmacist Consultant will report to the Manager of Medical Benefit Drug Utilization. In...
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Pharmacist, Consultant
2 weeks ago
Rancho Cordova, United States Blue Shield Of California Full timeYour Role The Pharmacy Services Drug Utilization Management team provides efficient and accurate responses to external customer (physicians, office staff, pharmacy providers, members and brokers) and internal team members for all outpatient medical benefit inquires. The Pharmacist Consultant will report to the Manager of Medical Benefit Drug Utilization. In...
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Pharmacist, Consultant
2 weeks ago
Rancho Cordova, United States Blue Shield of California Full timeYour Role The Pharmacy Services Drug Utilization Management team provides efficient and accurate responses to external customer (physicians, office staff, pharmacy providers, members and brokers) and internal team members for all outpatient medical benefit inquires. The Pharmacist Consultant will report to the Manager of Medical Benefit Drug Utilization. In...
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Pharmacist, Consultant
2 weeks ago
Rancho Cordova, United States Blue Shield of California Full timeYour Role The Pharmacy Services Drug Utilization Management team provides efficient and accurate responses to external customer (physicians, office staff, pharmacy providers, members and brokers) and internal team members for all outpatient medical benefit inquires. The Pharmacist Consultant will report to the Manager of Medical Benefit Drug Utilization. In...
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Pharmacist, Consultant
3 weeks ago
Rancho Cordova, United States Blue Shield of California Full timeYour Role The Pharmacy Services Drug Utilization Management team provides efficient and accurate responses to external customer (physicians, office staff, pharmacy providers, members and brokers) and internal team members for all outpatient medical benefit inquires. The Pharmacist Consultant will report to the Manager of Medical Benefit Drug Utilization. In...
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Pharmacist, Consultant
3 weeks ago
Rancho Cordova, United States Blue Shield of California Full timeYour Role The Pharmacy Services Drug Utilization Management team provides efficient and accurate responses to external customer (physicians, office staff, pharmacy providers, members and brokers) and internal team members for all outpatient medical benefit inquires. The Pharmacist Consultant will report to the Manager of Medical Benefit Drug Utilization. In...
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Pharmacist, Consultant
7 days ago
Rancho Cordova, United States Blue Shield of California Full timeYour RoleThe Pharmacy Services Drug Utilization Management team provides efficient and accurate responses to external customer (physicians, office staff, pharmacy providers, members and brokers) and internal team members for all outpatient medical benefit inquires. The Pharmacist Consultant will report to the Manager of Medical Benefit Drug Utilization. In...
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Pharmacist Consultant
3 weeks ago
Rancho Cordova, United States Blue Shield Of California Full timeYour Role The Pharmacy Services Drug Utilization Management team provides efficient and accurate responses to external customer (physicians, office staff, pharmacy providers, members and brokers) and internal team members for all outpatient medical benefit inquires. The Pharmacist Consultant will report to the Manager of Medical Benefit Drug Utilization. In...
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Pharmacist, Consultant
2 weeks ago
Rancho Cordova, CA, United States Blue Shield of California Full timeYour Role The Pharmacy Services Drug Utilization Management team provides efficient and accurate responses to external customer (physicians, office staff, pharmacy providers, members and brokers) and internal team members for all outpatient medical benefit inquires. The Pharmacist Consultant will report to the Manager of Medical Benefit Drug Utilization....
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Pharmacist, Consultant
3 weeks ago
United States, CA, Rancho Cordova Blue Shield of California Full timeYour Role The Pharmacy Services Drug Utilization Management team provides efficient and accurate responses to external customer (physicians, office staff, pharmacy providers, members and brokers) and internal team members for all outpatient medical benefit inquires. The Pharmacist Consultant will report to the Manager of Medical Benefit Drug Utilization. In...
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Pharmacist, Consultant
2 weeks ago
United States, CA, Rancho Cordova Blue Shield of California Full timeYour Role The Pharmacy Services Drug Utilization Management team provides efficient and accurate responses to external customer (physicians, office staff, pharmacy providers, members and brokers) and internal team members for all outpatient medical benefit inquires. The Pharmacist Consultant will report to the Manager of Medical Benefit Drug Utilization. In...
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Pharmacist, Consultant
7 days ago
Rancho Cordova, CA, United States Blue Shield of California Full timeYour Role The Pharmacy Services Drug Utilization Management team provides efficient and accurate responses to external customer (physicians, office staff, pharmacy providers, members and brokers) and internal team members for all outpatient medical benefit inquires. The Pharmacist Consultant will report to the Manager of Medical Benefit Drug Utilization. In...
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Pharmacy Business Consultant
5 days ago
Rancho Cordova, California, United States Blue Shield of California Full timeYour Role The Clinical Pharmacy Operations division is dedicated to the formulation, execution, coordination, and evaluation of pharmacy strategies aimed at delivering high-quality and cost-effective care to members of Blue Shield of California. The Experienced Business Analyst will report directly to the Senior Pharmacist Manager within the Clinical...
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Clinical Pharmacist
3 weeks ago
Rancho Cucamonga, United States Cross Country Workforce Solutions Group Full time $74Job DescriptionJob DescriptionPosition Summary:Under the direction of the Manager, Pharmacy Program, the Clinical Pharmacist is responsible to review prior authorizations, provide clinical recommendations to Providers, and provide clinical education and guidance to the pharmacy team. This position is Remote after onsite orientation for Southern California...
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Pharmacist for Long-Term Care Services
1 week ago
Rio Rancho, New Mexico, United States RPh on the Go Full timeJob OverviewWe are looking for a skilled and committed Staff Pharmacist to join our team at RPh on the Go, specializing in Long-Term Care (LTC) mail order pharmacy services. This full-time role is essential for ensuring the safe and effective management of medication dispensing.Position DetailsLocation: Albuquerque, NMShift: Monday - Friday, 2:00 PM - 11:00...
