Your Role
The Prior Authorization (PA) team utilizes clinical knowledge to review authorization requests for coverage under the outpatient pharmacy benefit. The Pharmacist-Consultant will work as part of the pharmacy benefit Prior Authorization (PA) team to support the Blue Shield of California (BSC) Pharmacy and Therapeutics Committee (P&T) by ensuring that evidence based clinical decisions are implemented appropriately to provide a high-quality and cost-effective pharmacy benefit. The Pharmacist- Consultant (Drug Utilization Review Pharmacist) will report to the Drug Utilization Review (DUR) Pharmacist Manager.
Our leadership model is about developing great leaders at all levels and creating opportunities for our people to grow - personally, professionally, and financially. We are looking for leaders that are energized by creative and critical thinking, building and sustaining high-performing teams, getting results the right way, and fostering continuous learning.
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
Requires experience working at a health plan (managed care, government payer, or academic)
1 year of prior authorization experience required
Experience working with formulary and medication policies required
Excellent oral and written communication skills
Thorough knowledge of therapeutic use of medications
Hybrid Virtual Work
This role allows employees to work virtually full-time, however employees will be expected to come to the office based on business need.
...returned to service.Setting the tone:Successful dishwashers know the importance of working in a team with positivity and "leaving our baggage at the door."They maintain a positive and professional approach with coworkers and customersCommunicates well with others and is a...
...Junior Loan Officer From your first day to your next promotion, Mutual of Omaha Mortgage invests in your career. We are looking for... ...Continued Training We understand you may not have Mortgage experience, or it's your first time doing Inside Sales. We provide extensive...
...Responsibilities Position Overview We are seeking experienced Federal EEO Investigators to conduct impartial administrative investigations of discrimination complaints in support of a federal Equal Opportunity Office. Each Investigator will independently plan and...
...Travel Booking Agent Hamilton, Bermuda Do you have a passion for travel and a talent for delivering exceptional customer service? We are... ...to work independently and manage time effectively in a remote setting Must be 18+ with reliable internet access and a dedicated...
Piedmont Airlines is seeking a motivated Ramp Agent to handle baggage, load/unload cargo, and service aircraft in a fast-paced outdoor airport setting. You will operate service vehicles, guide aircraft, and perform cabin maintenance while maintaining a strong commitment...