[Hiring] Clinical Pharmacist @BlueCross BlueShield of South Carolina

Role Description

Responsible for developing, implementing, maintaining, and evaluating pharmacy and medical-pharmacy formularies across all lines of business. This position serves as a clinical subject matter expert supporting formulary strategy, Pharmacy and Therapeutics (P&T) Committee decisions, coverage management programs, and formulary governance activities to ensure safe, effective, clinically appropriate, compliant, and cost-effective medication use while supporting organizational and member health outcomes.

Location: This position is located at 4101 Percival Road, Columbia SC. You will work the typical hours of 8am - 5pm, Monday through Friday. This position is eligible for a remote schedule after training.

What You'll Do:

• Develops, maintains, and optimizes pharmacy and medical-pharmacy formularies across assigned lines of business.
• Evaluates formulary performance, implements approved formulary decisions, and supports formulary governance activities to ensure accurate and timely formulary administration.
• Collaborates with internal and external stakeholders to support formulary design, implementation, and continuous improvement efforts.
• Evaluates clinical literature, treatment guidelines, FDA approvals, and therapeutic alternatives to support formulary decision-making.
• Prepares clinical reviews, drug monographs, and formulary analyses and provides recommendations regarding formulary additions, exclusions, restrictions, and other coverage strategies.
• Supports Pharmacy and Therapeutics Committee activities and implementation of approved recommendations.
• Supports formulary operational activities by maintaining the accuracy and integrity of formulary information within pharmacy systems, formulary databases, and vendor platforms.
• Supports formulary coding, configuration, and implementation activities, including maintenance and validation of drug classifications, NDC, HCPCS, J-code, GPI, and related formulary information.
• Performs testing, validation, and quality assurance activities to ensure formulary changes are accurately implemented and reflected in member-facing and provider-facing materials.
• Identifies and resolves issues that may affect benefit administration, claims processing, regulatory compliance, or member access to medications.
• Collaborates with Clinical Pharmacy and Utilization Management teams to ensure alignment between formulary strategies and medication management programs.
• Supports the implementation and administration of prior authorization, step therapy, quantity limit, site-of-care, and specialty medication strategies.
• Participates in initiatives designed to improve medication utilization, quality outcomes, affordability, and consistency across pharmacy and medical-pharmacy benefits.
• Supports compliance with applicable regulatory, accreditation, and organizational requirements related to formulary management activities.
• Maintains documentation supporting formulary decisions, participates in audits and regulatory reviews, and monitors industry and regulatory developments affecting pharmacy benefit management.
• Collaborates with cross-functional stakeholders to ensure effective implementation of formulary initiatives and achievement of business objectives.
• Assist in special projects as assigned by management.

Qualifications

• Doctor of Pharmacy (PharmD)
• 3 years of job-related experience
• Healthcare Common Procedure Coding Systems (HCPCS)
• Regulatory Knowledge
• Data Quality

Requirements

• Active, unrestricted Pharmacist license in the United States and state of hire.

Benefits

• Subsidized health plans, dental and vision coverage
• 401k retirement savings plan with company match
• Life Insurance
• Paid Time Off (PTO)
• On-site cafeterias and fitness centers in major locations
• Education Assistance
• Service Recognition
• National discounts to movies, theaters, zoos, theme parks and more