Utilization Management Pharmacist

Description

Why should you join the BlueCross BlueShield of South Carolina family of companies?

We are the largest insurance company in South Carolina and much more. We are one of the nation's leading administrators of government contracts. We operate one of the most sophisticated data processing centers in the Southeast. We also have a diverse family of subsidiary companies, allowing us to build on various business strengths. We deliver outstanding service to our customers.

Position Purpose

Responsible for performing utilization management reviews of prior authorization request for medications by applying clinical guidelines and criteria to ensure appropriate use of medications. Informs and educates patients and their providers about opportunities to optimize medication related outcomes, ensure patient safety, and utilize cost effective therapies. Collaborates with other health professionals to ensure that medications prescribed for patients contribute to the best possible health outcomes.

Location

This position is full-time (40-hours/week) Monday-Friday in a typical office environment. You will work an 8-hour shift between the hours of 7am - 7pm. This position is eligible for hybrid work after the training period. This role is located at 4101 Percival Road, Columbia, SC 29229. There is the expectation of rotating weekends and holidays as well.

To Qualify For This Position, You'll Need The Following Required Education

• Bachelor's in a job related field
• 3 years of clinical experience to include 1 year of experience with management of patient drug therapies that includes conducting utilization management and/or medication therapy management reviews

Required Work Experience

• Active, unrestricted pharmacy licensure in SC or state of residence

Required Skills and Abilities

• Strong clinical pharmacy knowledge
• Excellent communication (verbal and written), and interpersonal skills
• Ability to exercise good judgment with a capacity of communicating with a diverse range of individuals
• Ability to handle confidential or sensitive information with discretion
• Strong customer service skills
• Commitment to professionalism and to advance patient care

Preferred Training

• Any additional certifications in Medication Therapy Management, immunotherapy, oncology, hemophilia, multiple sclerosis, or specialty related disease states is helpful

Preferred Work Experience

• Utilization Management program experience preferred including working with prior authorization program platforms
• Managed Medicaid experience working with preferred drug lists and UM criteria application

Preferred Skills and Abilities

• Knowledge and expertise with management of specialty drug therapies

Comprehensive Benefits Package

• Subsidized health plans, dental and vision coverage
• 401k retirement savings plan with company match
• Life Insurance
• Paid Time Off (PTO)
• On-site cafeterias and fitness centers in major locations
• Education Assistance
• Service Recognition
• National discounts to movies, theaters, zoos, theme parks and more

What We Can Do For You

• We understand the value of a diverse and inclusive workplace and strive to be an employer where employees across all spectrums have the opportunity to develop their skills, advance their careers and contribute their unique abilities to the growth of our company.

Equal Employment Opportunity Statement

BlueCross BlueShield of South Carolina and our subsidiary companies maintain a continuing policy of nondiscrimination in employment to promote employment opportunities for persons regardless of age, race, color, national origin, sex, religion, veteran status, disability, weight, sexual orientation, gender identity, genetic information or any other legally protected status. Additionally, as a federal contractor, the company maintains affirmative action programs to promote employment opportunities for individuals with disabilities and protected veterans. It is our policy to provide equal opportunities in all phases of the employment process and to comply with applicable federal, state and local laws and regulations. We are committed to working with and providing reasonable accommodations to individuals with disabilities, pregnant individuals, individuals with pregnancy-related conditions, and individuals needing accommodations for sincerely held religious beliefs, provided that those accommodations do not impose an undue hardship on the Company. If you need special assistance or an accommodation while seeking employment, please email mycareer.help@bcbssc.com or call 800-288-2227, ext. 47480 with the nature of your request. We will make a determination regarding your request for reasonable accommodation on a case-by-case basis. We participate in E-Verify and comply with the Pay Transparency Nondiscrimination Provision. We are an Equal Opportunity Employer. Here's more information. Some states have required notifications. Here's more information.