Ourhrconnect

Ourhrconnect

Utilization Management Pharmacist

Columbia, South Carolina · Contract

Sponsorship not specifiedDetected 1 day ago
Customer SupportPharmacologyPharmacy PracticeCommunication

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Cap-exempt (no lottery)0
Sponsors this role0
Entry-level history0
PERM / green-card track0
Lottery odds40
Fits your clock70

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About the role

  • Description Why should you join the BlueCross BlueShield of South Carolina family of companies?
  • We operate one of the most sophisticated data processing centers in the Southeast.
  • If you are dedicated to the same philosophy, consider joining our team!

Responsibilities

  • Formulates recommendations to optimize the patients' medication regiment applying evidence based medicine and national treatment guidelines.
  • 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.
  • patients and their providers about opportunities to optimize medication related outcomes, ensure
  • We also have a diverse family of subsidiary companies, allowing us to build on various business strengths.
  • We deliver outstanding service to our customers.
  • Informs and educates patients and their providers about opportunities to optimize medication related outcomes, ensure patient safety, and utilize cost effective therapies.

Requirements

  • 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 Skills and Abilities: Strong clinical pharmacy knowledge.
  • Required Software and Tools: Microsoft Office.
  • Required Licenses and Certificates: Active, unrestricted pharmacy licensure in SC or state of residence.

Nice to have

  • Any additional certifications in Medication Therapy Management, immunotherapy, oncology, hemophilia, multiple sclerosis, or specialty related disease states is helpful.
  • 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 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.
  • Preferred Skills and Abilities: Knowledge and expertise with management of specialty drug therapies.

Skills

  • 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.
  • Required Software and Tools:
  • Required Licenses and Certificates:
  • Active, unrestricted pharmacy licensure in SC or state of residence.
  • We Prefer That You Have The Following:
  • Subsidized health plans, dental and vision coverage
  • 401k retirement savings plan with company match

Compensation

  • This may include a brief telephone interview or email communication with our recruiter to verify resume specifics and salary requirements.

Benefits

  • Collaborates with other health professionals to ensure that medications prescribed for patients contribute to the best possible health outcomes.
  • Conducts utilization management prior authorization reviews and evaluates opportunities to improve health outcomes and derive optimal value from health care resources.

Company info

  • Other companies come and go, but we've been part of the national landscape for more than seven decades, with our roots firmly embedded in the South Carolina community.
  • We are the largest insurance company in South Carolina … and much more.
  • We are one of the nation's leading administrators of government contracts.

Equal opportunity

  • 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.
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