Mar 25, 2026
CareFirst BlueCross BlueShield
Resp & Qualifications PURPOSE: The Clinical Pharmacist will perform comprehensive clinical services with a focus on utilization management for specialty drugs covered under the pharmacy and medical benefit. Responsibilities will include but not are limited to utilization management program development and monitoring, coverage criteria development, clinical drug evaluations, development of drug management tools, and vendor oversight for delegated programs. This position will work in a matrixed environment across the organization. ESSENTIAL FUNCTIONS: Develops and executes on strategies to manage pharmacy and medical benefit drug spend with a focus on specialty drugs. Tracks productivity, quality, impact, and overall performance of utilization management strategies. Identifies areas where program modifications could result in improvements to patient outcomes and reduce costs. Works collaboratively with vendors, PBMs, and internal...
Professional Diversity Network
Baltimore, MD, USA
Full-Time
