Medical Director
4 days ago
The Blue Shield of California is seeking a highly skilled Pharmacist, Consultant to join its team. In this role, you will provide pharmacotherapy expertise to support the company's pharmacy program, including the Pharmacy and Therapeutics Committee, drug formulary, and utilization review programs.
You will work closely with internal teams to ensure compliance with regulatory and accreditation requirements, and corporate policies and procedures related to medication use. This includes preparing materials for audits and reports, completing projects as assigned, and supporting the operational and clinical implementation of medication policies.
Your Responsibilities- Provide clinical expertise to support the prior authorization program by reviewing requests within regulatory required time frames.
- Facilitate provider discussion regarding prior authorization denials through peer-to-peer process.
- Serve as an educational resource to internal and external constituents regarding the Blue Shield drug formulary, medication policies, and appropriate drug use.
To be successful in this role, you will require a Doctor of Pharmacy (Ph.D.) degree, a currently active and unrestricted California Registered Pharmacist (RPh) license, and at least 2 years of experience in clinical pharmacy. Prior experience in managed care/PBM is preferred.
You should have thorough knowledge of therapeutic use of medications, excellent oral and written communication skills, and be able to work at least one weekend per month and company holidays as needed to ensure regulatory compliance.
What We OfferThe pay range for this role is $118,800.00 to $178,200.00 for California. As a valued member of our team, you will also receive competitive benefits and opportunities for growth and development.
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