Engagement Description -
The pharmacist will review Part B medical drug prior authorization requests according to CMS regulations and clinical coverage criteria. Call prescribers and infusion centers to confirm information, deliver case outcomes, and discuss clinical information. Responsible for promoting appropriate and/or efficient utilization review of prescription drug claims among BCBSM participating physicians. This position is also responsible for the education of physicians and influencing of prescribing patterns to reduce BCBSM's drug benefit payout and improve the quality of the benefits as it relates to our members. The incumbent serves as the liaison to the Medical Policy department assisting with the development of medical policy as it applies to drugs. Bachelor's Degree or Doctorate in Pharmacy required. The Clinical Pharmacist must have at least three (3) years of experience consulting with physicians on pharmaceutical issues or completion of an accredited American Society of Health-System Pharmacists (ASHP) or Academy of Managed Care Pharmacy (AMCP) or Managed Care Pharmacy or Pharmacy Practice Residency. Current unrestricted Michigan pharmacy license. Experience as a Clinical Pharmacist is required for the Clinical Pharmacist job classification. Drug Information Specialist with proven background and skills will also be considered. **Medical Drug (Part B) Prior Authorization Pharmacist**

Top 3 Required Skills/Experience -
• Microsoft office suite proficiency
• Hospital or retail pharmacy experience
• Excellent communication skills (verbal and written)

Required Skills/Experience - The rest of the required skills/experience. Include:
• Microsoft office suite proficiency
• Hospital or retail pharmacy experience
• Excellent communication skills (verbal and written)
• Ability to make independent decisions

Education/Certifications - Include:
• PharmD or BS Pharmacy
• Active and unrestricted pharmacist license in State of Michigan