Clinical Pharmacy Specialist:
Blue Cross Blue Shield of Tennessee

1259539641
Blue Cross Blue Shield of Tennessee
Chattanooga Tennessee
Pharmaceutical
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Description
Perform activities that support pharmacy management in the administration of drug benefits including participation in processes required for daily operations of pharmacy reviews, clinical pharmacy programs, vendor activities, and daily oversight and monitoring.

Job Description:

Job Responsibilities

  • Triage requests by providers and/or members/members representatives for pharmacy prior authorizations, exceptions, and appeals
  • Enter authorizations and test claims into the pharmacy benefit system to ensure appropriate claim adjudication
  • Perform system edits, data entry, and complete tracking logs
  • Assist with departmental audits and quality improvement activities

Job Qualifications

Education

  • High School Diploma or equivalent

Experience

  • 2 years - Pharmacy experience required

Skills\Certifications

  • National Certification as Pharmacy Technician (PTCB)
  • Proficient in Microsoft Office (Outlook, Word, Excel and Powerpoint)
  • Must be a team player, be organized and have the ability to handle multiple projects
  • Excellent oral and written communication skills
  • Strong interpersonal and organizational skills
  • Proven decision making and problem solving skills
  • Ability to work independently and with minimal supervision
  • Knowledge in Medical terminology

Job Specific Requirements:

Candidates with MHK experience strongly preferred. This is a customer service position to assist providers with pharmacy prior authorizations.

Preferred Skills:

Number of Openings Available:

2

Worker Type:

Employee

Worker Sub-Type:

FlexHome

Company:

BCBST BlueCross BlueShield of Tennessee, Inc.

Applying for this job indicates your acknowledgement and understanding of the following statement:

BCBST is an Equal Opportunity employer (EEO), and all employees and applicants will be entitled to equal employment opportunities when employment decisions are made. BCBST will take affirmative action to recruit, hire, train and promote individuals in all job classifications without regard to race, religion, color, age, sex, national origin, citizenship, pregnancy, veteran status, sexual orientation, physical or mental disability, gender identity, or any other characteristic protected by applicable law.

Further information regarding BCBST's EEO Policies/Notices may be found by reviewing the following page:

BCBST's EEO Policies/Notices

BlueCross BlueShield of Tennessee is not accepting unsolicited assistance from search firms for this employment opportunity. All resumes submitted by search firms to any employee at BlueCross BlueShield of Tennessee via-email, the Internet or any other method without a valid, written Direct Placement Agreement in place for this position from BlueCross BlueShield of Tennessee HR/Talent Acquisition will not be considered. No fee will be paid in the event the applicant is hired by BlueCross BlueShield of Tennessee as a result of the referral or through other means.

Tobacco-Free Hiring Statement

T o further our mission of peace of mind through better health, effective 2017, BlueCross BlueShield of Tennessee and its subsidiaries no longer hire individuals who use tobacco or nicotine products (including but not limited to cigarettes, cigars, pipe tobacco, snuff, chewing tobacco, gum, patch, lozenges and electronic or smokeless cigarettes) in any form in Tennessee and where state law permits. A tobacco or nicotine free hiring practice is part of an effort to combat serious diseases, as well as to promote health and wellness for our employees and our community. All offers of employment will be contingent upon passing a background check which includes an illegal drug and tobacco/nicotine test. An individual whose post offer screening result is positive for illegal drugs or tobacco/nicotine and/or whose background check is verified to be unsatisfactory, will be disqualified from employment, the job offer will be withdrawn, and they may be disqualified from applying for employment for six (6) months from the date of the post offer screening results.

Resources to help individuals discontinue the use of tobacco/nicotine products include smokefreegov or 1-800-QUIT-NOW.