Role Description This position is responsible for maintaining and supporting the Medicare and/or Medicaid formulary and providing clinical and economic data necessary to make formulary decisions. This position acts as a pharmacy resource for network physicians, health plan members, medical services, care management, and member service staffs as well as other internal partners. Assists in performing all CMS mandated quality and compliance activities. Serves as a pharmacy topic educator and training resource to Medicare and/or Medicaid health plan departments and personnel. This position has the latitude for independent decision-making within the limits of acceptable standards of pharmacy practice and state and federal laws. This position requires interactions at all levels of staff and management. External interactions include network physicians, and health plan members, etc. Qualifications - 5 years or more as a practicing pharmacist - 3 years of experience in the managed care pharmacy field - 2 years of direct prior authorization experience - 2 years of managed care/health plan and/or pharmacy benefits experience - Doctor of Pharmacy (Pharm.D) degree - Active, current and unrestricted State of Arizona pharmacist license - Medicare Part D experience highly desirable (preferred) - Pharm. D with residency or fellowship preferred (preferred) - Geriatric certification (preferred) Requirements - Proficient in critical literature evaluation skills, including evidence-based medicine principles - Excellent problem-solving skills - Strong written and verbal communications - Intermediate PC proficiency - Intermediate skill in use of office equipment, including copiers, fax machines, scanner and telephones - Intermediate skill in word processing, spreadsheet and database software - Intermediate skill using departmental BCBSAZ and BCBSA software - Must have effective human relations and verbal/written communication skills - Must have an understanding of the interrelationships of health plan pharmacy components, members, and providers - Proficiency with PC based productivity tools required - Needs analytical ability to support decision making - Flexible skills in an operationally changing environment - Strong customer service skills - Interpersonal skills that allow for harmonious relationships with providers, members and coworkers - Recognize strategic opportunities and use data to make timely and sound decisions - Flexibility and willingness to adjust to shifting demands/priorities Benefits - Remote work opportunity requires residency within the State of Arizona - Hybrid workforce strategy offers flexibility with how and where employees work - Onsite requirements may change based on business need and job responsibilities Company Description Awarded a Healthiest Employer, Blue Cross Blue Shield of Arizona aims to fulfill its mission to inspire health and make it easy. AZ Blue offers a variety of health insurance products and services to meet the diverse needs of individuals, families, and small and large businesses as well as providing information and tools to help individuals make better health decisions.