CareFirst Careers

Clinical Pharmacist - Utilization Review (Hybrid)

Resp & Qualifications

The Clinical Pharmacist will serve in a client-facing role supporting pharmacy sales functions with large national accounts.  Responsibilities will include but not are limited to; account presentations, account-specific pharmacy utilization review, development of pharmacy recommendations, RFPs, and pharmacy market reviews. The pharmacist will represent CareFirst pharmacy to a variety of stakeholders, including brokers, key employer accounts, and internal sales teams. 


Develops and conducts account-specific presentations to present pharmacy utilization, market insights, clinical pharmacy programs, pharmacy strategy, and other pharmacy topics. Attends and acts as a pharmacy subject matter expert during account presentations including new business and account utilization review meetings; Provides expertise to accounts regarding national, local, and account specific pharmacy trends.

Tracks and analyzes account-specific pharmacy data and overall performance of pharmacy programs, formularies, and/or utilization management. Identifies areas of opportunities where program modifications could result in improvements to patient outcomes and reduce pharmacy costs. Works collaboratively with vendors, PBMs, accounts, and internal parties for oversight of programs and performance management.

Participates in the RFP process for new pharmacy business including but not limited to serving as a clinical pharmacy resource for written RFP response and presenting at finalist meetings.

Acts as a consultant for internal sales to develop a trusted consultative partnership that drives client satisfaction.

Reviews pharmacy market information including drug approvals, trends, and competitor offerings to develop and coordinate the implementation of appropriate strategies or programs for cost containment and clinical management.


Education Level: Medical Degree in Pharmacy (Doctorate of Pharmacy).

Experience: 5 years experience in clinical pharmacy, preferably in a managed care environment.

Preferred Qualifications:

  • Experience in account management/sales role.
  • Experience working in healthcare industry with a thorough understanding of prescription benefit management programs and practices.

Knowledge, Skills and Abilities (KSAs)

  • Ability to work independently, as well as a member of a team.
  • Strong critical reasoning skills in clinical decision-making, planning and organizing.
  • Current knowledge of clinical practices and related information systems and computer applications, required.
  • A strong balance between clinical expertise and business acumen.
  • Strong interpersonal, written and verbal communication skills, including presentation skills.

Licenses/Certifications: PHARMD - Licensed Pharmacist Active Maryland Registered Pharmacist Upon Hire Required.
Salary Range: $111,920 - $200,057

Salary Range Disclaimer

Salary will be based on education, location, experience, certifications, etc. In addition to your salary, CareFirst offers benefits such as a comprehensive benefits package, incentive and recognition programs, and 401k contribution (all benefits are subject to eligibility requirements).



Equal Employment Opportunity

CareFirst BlueCross BlueShield is an Equal Opportunity (EEO) employer.  It is the policy of the Company to provide equal employment opportunities to all qualified applicants without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, age, protected veteran or disabled status, or genetic information.

Where To Apply

Please visit our website to apply:

Federal Disc/Physical Demand

Note:  The incumbent is required to immediately disclose any debarment, exclusion, or other event that makes him/her ineligible to perform work directly or indirectly on Federal health care programs.


The associate is primarily seated while performing the duties of the position.  Occasional walking or standing is required.  The hands are regularly used to write, type, key and handle or feel small controls and objects.  The associate must frequently talk and hear.  Weights up to 25 pounds are occasionally lifted.

Sponsorship in US

Must be eligible to work in the U.S. without Sponsorship.


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