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Blue Cross Pharmacist Jobs (NOW HIRING)

Capital Blue Cross

Clinical Pharmacist - PBM

Harrisburg, PA · On-site +1

$116K - $139K/yr

Capital Blue Cross offers a comprehensive benefits packaging including Medical, Dental & Vision ... Pharmaceutical utilization and trend management via pharmacy clinical initiatives * PBM vendor ...

Blue Cross Blue Shield of Wyoming

Health Plan Pharmacist

$59.50 - $71.75/hr

We are Blue Cross Blue Shield Wyoming: a not-for-profit health insurer with offices throughout the ... As a Health Plan Pharmacist with the BCBSWY Pharmacy Team, you will play an essential role in ...

Mission Hospital

Pharmacist - Inpatient Pharmacist

Salina, KS · On-site

$55.25 - $66.50/hr

... Pharmacist Specialty Inpatient Pharmacist Job ID 35932054 Job Title Pharmacist - Inpatient ... Low-Cost Blue Cross Blue Shield health insurance * Around the clock support * Your own personal ...

Modoc Medical Center

Inpatient Pharmacist

Alturas, CA · On-site

Pharmacist - Inpatient Pharmacist MedWave Healthcare Staffing is currently seeking an Inpatient ... Low-Cost Blue Cross Blue Shield health insurance * Around the clock support * Your own personal ...

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Blue Cross Pharmacist information

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How much do blue cross pharmacist jobs pay per hour?

As of Aug 24, 2026, the average hourly pay for blue cross pharmacist in the United States is $60.91, according to ZipRecruiter salary data. Most workers in this role earn between $56.01 and $67.31 per hour, depending on experience, location, and employer.

What is a Blue Cross pharmacist?

A Blue Cross Pharmacist is a licensed pharmacist who works for a Blue Cross Blue Shield (BCBS) health insurance company or affiliated organization. They help manage prescription drug benefits, review medication claims, ensure compliance with formulary guidelines, and provide support for members and healthcare providers. Their role may also involve medication therapy management, prior authorization reviews, and cost-saving initiatives to improve patient care.

What are the typical daily responsibilities of a Blue Cross pharmacist?

As a Blue Cross Pharmacist, your daily responsibilities often include reviewing and approving prescription claims, providing clinical guidance to both members and healthcare providers, and ensuring medications are covered within plan formularies. You may also collaborate with physicians to discuss alternative therapies when coverage issues arise and participate in quality improvement initiatives. Interpreting insurance policies and helping resolve member inquiries are common tasks, as is working closely with a multidisciplinary team to optimize medication use and control costs. This dynamic role requires a combination of clinical expertise, attention to detail, and strong customer service skills to support members' health outcomes effectively.

What are the key skills and qualifications needed to thrive in the Blue Cross pharmacist position, and why are they important?

To thrive as a Blue Cross Pharmacist, you need a Doctor of Pharmacy (PharmD) degree, a valid pharmacist license, and a solid understanding of managed care pharmacy practices. Experience with pharmacy benefit management (PBM) systems, prescription adjudication software, and knowledge of insurance formularies is typically required. Strong analytical thinking, attention to detail, and effective communication are crucial soft skills for this role. These skills ensure accurate medication reviews, compliance with regulatory policies, and seamless coordination between healthcare providers, insurers, and patients.

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Blue Cross Pharmacist jobs near you
Infographic showing various Blue Cross Pharmacist job openings in the United States as of August 2026, with employment types broken down into 85% Full Time, and 15% Part Time. Highlights an 90% In-person, 5% Hybrid, and 5% Remote job distribution, with an average salary of $126,701 per year, or $60.9 per hour.

Clinical Pharmacist - PBM

Capital Blue Cross

Harrisburg, PA • On-site, Remote

$98K/yr

Full-time

Medical, Dental, Vision, Retirement, PTO

Re-posted 13 days ago

Capital Blue Cross rating

7.7

Company rating: 7.7 out of 10

Based on 13 frontline employees who took The Breakroom Quiz

207th of 311 rated insurance

Job description

Position Description
Base pay is influenced by several factors including a candidate's qualifications, relevant experience, and anticipated contributions to meet the needs of the business, along with internal pay equity and external market driven rates. The salary range displayed has not been adjusted for geographical location. This range has been created in good faith based on information known to Capital Blue Cross at the time of posting and may be modified in the future. Capital Blue Cross offers a comprehensive benefits packaging including Medical, Dental & Vision coverage, a Retirement Plan, generous time off including Paid Time Off, Holidays, and Volunteer time off, an Incentive Plan, Tuition Reimbursement, and more.
At Capital Blue Cross, we promise to go the extra mile for our team and our community. This promise is at the heart of our culture, and it's why our employees consistently vote us one of the "Best Places to Work in PA."
This position is responsible for the development, maintenance, and evaluation of pharmacy clinical initiatives and utilization management programs to assure a consistently cost-effective and quality pharmaceutical services and benefits for plan members. The incumbent manages the drug formulary program as well as clinical activities and oversees the clinical program administration by the pharmacy benefit management (PBM) company. The incumbent also serves as a resource to providing clinical support to committees and workgroups such as Pharmacy and Therapeutics Committee, Medical Policy Committee, Quality Management Committee, Delegation Oversight, and HEDIS/NCQA. The incumbent possesses good clinical/analytical skills and sound decision-making capabilities to identify opportunities/risks and propose benefit program quality/utilization management strategies accordingly. Strong interpersonal and excellent communication skills are essential due to interaction with various members of the medical profession, managed care clients, and external organizations.
Responsibilities and Qualifications
  • Formulary management including drug evaluation, P&T Committee, and related physician and member collaterals
  • Pharmaceutical utilization and trend management via pharmacy clinical initiatives
  • PBM vendor clinical services and programs oversight
  • Specialty pharmaceutical management
  • Pharmacy clinical and utilization management criteria, protocol, policies, and procedure development
  • Provide clinical and drug information support
  • Maintain regulatory including Medicare Part D, and accreditation compliance
  • Develop member and provider educational programs
  • Conduct presentation and training
  • Maintain provider and pharmaceutical industry/drug manufacturer relations.
  • Staff supervision

Skills:
  • Strong interpersonal and team skills with ability to work and interact externally and internally. Ability to communicate effectively with varied audiences, including ability to lead meetings, develop teamwork, and deliver verbal presentations. Ability to take direction from various levels of staff and perform project work with minimal supervision.
  • Strong clinical/analytical skills and decision-making capabilities required. Strong interpersonal and excellent communication skills required. Ability to assess utilization data to identity new opportunities.

Knowledge:
  • Managed care knowledge and experience preferred. In-depth knowledge of drug formulary systems and drug evaluation process. Broad knowledge of outpatient drug benefit and utilization management programs.
  • Knowledge of pharmacy claims processing along with applicable state/federal laws.
  • Knowledge and experience with Medicare Part D and NCQA accreditation preferred. Knowledge and experience with therapy medication and disease state management.
  • Possess working knowledge of medical and pharmacy data integration to close gap in care and facilitate greater care coordination.

Experience:
  • Experience in developing pharmacy clinical protocol, policies, and procedures. Experience in design/deployment of programs to increase quality of care and decrease costs.

Education and Certifications:
  • Pharmacy degree and current Pennsylvania pharmacy license required. Advanced pharmacy degree (Masters or Pharm.D.) preferred.

Location:
  • This position is classified hybrid, which requires onsite work on Tuesdays and Wednesdays.

Work Environment:
  • Working environment includes typical office conditions.

Physical Demands:
  • While performing the duties of the job, the employee is frequently required to sit, use hands and fingers, talk, hear, and see.
  • The employee must be able to work over 40 hours per week.
  • The employee must occasionally lift and/or move up to 5 pounds.
  • Sedentary work involving significant periods of sitting, talking, hearing, keying and performing repetitive motions. Work requires visual acuity to perform close inspection of written and computer generated documents as well as a PC monitor.

Other:
  • Performs other related duties and assignments as directed.
  • Travel less than 1%. Occasional overnight travel and travel between CBC locations.

About Us
We recognize that work is a part of life, not separate from it, and foster a flexible environment where your health and wellbeing are prioritized. At Capital you will work alongside a caring team of supportive colleagues, and be encouraged to volunteer in your community. We value your professional and personal growth by investing heavily in training and continuing education, so you have the tools to do your best as you develop your career. And by doing your best, you'll help us live our mission of improving the health and well-being of our members and the communities in which they live.

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