Clinical Pharmacy Specialist
Employment type
Full-time
Work setting
On-site
Location
Chattanooga, TN
Schedule
Evening shift
Posted
You'll be redirected to the employer's application page.
Job overview
The Clinical Pharmacy Specialist is described as remote and associated with Chattanooga, TN; compensation is not specified. The role supports Medicare and D-SNP coverage review activities for BlueCross BlueShield of Tennessee members. The specialist processes pharmacy authorizations and claims, communicates with providers and members, and supports coverage determinations and appeals. Accurate review and timely case handling help members access pharmacy benefits and services.
What you'll do
- Enter authorizations and test claims in the pharmacy benefit system
- handle calls from providers and members regarding coverage determinations and appeals
- monitor email and FACETs inquiries
- review daily pharmacy reports
- assist with audits and quality improvement
- may work evenings, holidays, weekends, and on-call rotations to meet coverage needs.
What we're looking for
- Skills & competencies
- clinical pharmacy specialistpharmacy benefitsmedicared-snpcoverage reviewauthorizationsclaimsappealschattanooga tnbluecross blueshield of tennessee
- Work arrangement
- Weekend coverage required
Why this role
Requires two years of pharmacy experience and national Pharmacy Technician Certification (PTCB); schedule is Monday–Friday, 8 a.m.–6 p.m. EST, with rotating night and weekend availability.
About the employer
BlueCross BlueShield of Tennessee is hiring for this role. Industry: Pharmacy Benefit Management and Other Third Party Administration of Insurance and Pension Funds. Sector: 52.
Additional details
- Industry sector
- 52
- Industry
- Pharmacy Benefit Management and Other Third Party Administration of Insurance and Pension Funds
- Occupation code
- 29-1051.00
You'll be redirected to the employer's application page.
Listing ID: e891abe7-fc5e-4577-a854-204e21bf8889