**Job Description** We are seeking a Clinical Pharmacist to join our team! As a Clinical Pharmacist, you will provide timely drug therapy for health plan members by reviewing and processing prior authorization requests using clinical judgment and medical policy. *****Note: The designated shift for this position will be 10 AM - 7 PM EST (Monday - Friday)***** **What You Will Do** + Review prior authorization requests and make determinations for drug products according to member benefits and coverage criteria + Report utilization review statistics to corporate compliance committees + Review data and summarize daily utilization review numbers + Responsible for tracking compliance of review cases + Provide clinical guidance and support to the assigned pharmacy technicians + Knowledge of drug coding (NDC, GCN, GPI and USC) and NCPDP claims adjudication systems + Review guideline criteria for prior authorization and non-formulary drugs in support of Pharmacy and Therapeutics Committee function and pharmacy benefit design. + Ensure and evaluate quality controls and implement opportunities for performance improvement in pharmacy practices + Research drug information to maintain drug knowledge and disease state understanding for application to prior authorization reviews **What You Bring** + Bachelor's degree or advanced degree + 3+ years of experience in related field + Licensed NC pharmacist or eligible for licensure in North Carolina. **Bonus Points (preferred qualifications)** + Background in ambulatory care and/or retail pharmacy environments. + Strong ability to engage with patients and health plan members in a professional and empathetic manner. + Excellent communication skills tailored to customer, patient, and member needs. + Familiarity with a wide range of disease states and chronic conditions. + Working knowledge of Medicare programs and processes. + Experience serving the geriatric population, with sensitivity to their unique healthcare needs. **What You’ll Get** + The opportunity to work at the cutting edge of health care delivery with a team that’s deeply invested in the community + Work-life balance, flexibility, and the autonomy to do great work + Medical, dental, and vision coverage along with numerous health and wellness programs + Parental leave and support plus adoption and surrogacy assistance + Career development programs and tuition reimbursement for continued education + 401k match including an annual company contribution **Salary Range** At Blue Cross NC, we take great pride in a fair and equitable compensation package that reflects market-price and our starting salaries are typically planned near the middle of the range listed. Compensation decisions are driven by factors including experience and training, specialized skill sets, licensure and certifications and other business and organizational needs. Our base salary is part of a robust Total Rewards package that includes an Annual Incentive Bonus*, 401(k) with employer match, Paid Time Off (PTO), and competitive health benefits and wellness programs. _*Based on annual corporate goal achievement and individual performance._ $118,691.00 - $189,906.00 **Skills** **About Us** It's an exciting time to work at Blue Cross and Blue Shield of North Carolina (Blue Cross NC). Health care is changing, and we're leading the way. We offer more than health insurance our customers can count on. We’re committed to better health and better health care − in our communities and beyond. Our employees bring energy and creativity to the workplace, and it shows in our innovative approach to improving the health and well-being of North Carolinians. Blue Cross NC is a fully taxed, not-for-profit company headquartered in Durham, North Carolina. We serve more than 4.3 million members, and we employ more than 5,000 people across the country who are passionate about making health care better for all. Help us lead the charge for better health care by joining our award-winning team. Discover tremendous opportunities with us to do challenging and rewarding work. Opportunities that can lead you to a fulfilling career, work that can help others lead healthier, happier lives. **Authorization to Work in the United States** We use E-verify to confirm authorization to work in the United States. To learn more about E-Verify, including your rights and responsibilities, please visit E-Verify Overview (https://www.e-verify.gov/employees/e-verify-overview) for English or Visión General de E-Verify (https://www.e-verify.gov/es/empleados/vision-general-de-e-verify) for Español. **Request Accommodations** Blue Cross NC provides reasonable accommodations to applicants with disabilities. If you need a reasonable accommodation for any part of the application or hiring process, please notify HR at HR.Staffing@bcbsnc.com . **For most roles, you can choose where to work - fully remote in one of the states listed below, in the office, or a hybrid of the two:** Alabama, Arizona, Arkansas, Colorado, Florida, Georgia, Idaho, Indiana, Iowa, Kansas, Kentucky, Louisiana, Maryland, Michigan, Mississippi, Missouri, North Carolina, Ohio, Oklahoma, Pennsylvania, South Carolina, South Dakota, Tennessee, Texas, Utah, Virginia, Wisconsin, and Wyoming