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Pharmacist - Medication Prior Authorization and Clinical Program Specialist
2 months ago
We are seeking a highly skilled Pharmacist to join our team at Blue Cross Blue Shield of Arizona. As a Pharmacist - Medication Prior Authorization and Clinical Program Specialist, you will play a critical role in ensuring the quality and safety of our members' medication therapy.
Key Responsibilities- Review and make determinations on prior authorization requests for medication therapy, ensuring compliance with member benefits and established treatment protocols.
- Develop and maintain clinical criteria for review of non-formulary or non-preferred medication requests, in collaboration with the Pharmacy and Therapeutics Committee.
- Provide clinical guidance and support to pharmacy technicians, ensuring accurate and timely processing of medication therapy requests.
- Collaborate with healthcare providers to develop and implement medication therapy plans, ensuring optimal patient outcomes.
- Stay up-to-date with industry trends and developments, applying this knowledge to inform clinical decision-making and improve medication therapy outcomes.
- Doctor of Pharmacy (Pharm.D) degree from an accredited institution.
- Active, current, and unrestricted State of Arizona pharmacist license.
- Minimum 1 year of experience in specialty medications or direct prior authorization experience.
- Excellent problem-solving skills, with the ability to analyze complex medication therapy data and make informed decisions.
- Strong written and verbal communication skills, with the ability to effectively collaborate with healthcare providers and other stakeholders.
- 5 years of experience as a practicing pharmacist.
- 3 years of experience in the managed care pharmacy field.
- 2 years of direct prior authorization experience.
- Working knowledge of LexiComp, Facts and Comparisons, Micromedex, UptoDate, National guidelines, NCCN, and other relevant clinical resources.
- A competitive salary and benefits package.
- Opportunities for professional growth and development, including training and education programs.
- A collaborative and supportive work environment, with a team of experienced healthcare professionals.
The primary language used in this role is English.
