Clinical Pharmacy Specialist

We are hiring a Clinical Pharmacy Specialist at BCBST! In this role, you will support Commercial and Exchange coverage review activities, helping ensure members receive timely and appropriate access to pharmacy benefits and services. You’ll work closely with pharmacists and healthcare providers to build and manage cases, contributing to important coverage determinations that directly impact member care and health outcomes. You will contribute to team success by balancing independent work with collaboration across the pharmacy team. This role offers the opportunity to develop specialized knowledge in coverage review while serving as a key resource in the review process. You’ll engage with providers, manage multiple priorities, and play an important part in delivering high-quality service to both members and providers. To be successful in this position, you’ll bring strong computer and organizational skills, attention to detail, and the ability to navigate complex information in a remote environment. Ideal candidates will have experience in Medicare, Medicaid, retail pharmacy, or managed care settings. Previous experience with coverage review processes will help support a smoother t…