Full-Time

Clinical Pharmacist

Formulary

Posted on 8/27/2025

Premera Blue Cross

Premera Blue Cross

1,001-5,000 employees

Health benefits plans and related services

Compensation Overview

$105.2k - $203.8k/yr

Washington, USA

Remote

Hiring in multiple states including Alaska, Arizona, Arkansas, California, Colorado, Florida, Georgia, Idaho, Iowa, Kansas, Kentucky, Maine, Michigan, Minnesota, Missouri, Montana, Nevada, New Hampshire, New Mexico, North Carolina, Oklahoma, Oregon, South Carolina, South Dakota, Tennessee, Texas, Utah, Washington, Wisconsin.

Category
Medical, Clinical & Veterinary (1)
Requirements
  • Pharmacist Degree.
  • Active US Pharmacist license in good standing.
  • Clinical pharmacy training, clinical residency training from an accredited Pharmacy program.
  • Two years’ experience as a pharmacist.
Responsibilities
  • Develop and manage formulary strategies, including tier placement, exclusions, and preferred drug selections using pharmacoeconomic and utilization data.
  • Collaborate on RFPs, client consulting, and other functional areas to ensure clinical criteria are embedded in contracting processes.
  • Partner with PBM partners on rebate strategy and coding, and with actuarial and clinical operations teams to assess rebate opportunities and model financial impacts of formulary decisions.
  • Provide leadership and support for the P&T Committee, including implementing strategic changes in service of broader formulary and departmental long-term plans. Drive formulary updates and maintenance across multiple lines of business, ensuring strategic alignment, regulatory compliance, and cost-effective, clinically sound drug coverage decisions.
  • Continuously review and adapt to regulatory and accreditation requirements (ACA, WA OIC, AK DOI, NCQA, HEDIS). Support medical management and clinical pharmacy initiatives through research, analyses, and administration of clinical drug utilization management programs.
  • Assist in administering Pharmacy Prior Authorization and other clinical pharmacy programs. Identify and help resolve drug-related issues in collaboration with medical services staff to optimize medication therapy and improve clinical outcomes.
  • Develop and maintain provider and member communication materials that support clinical pharmacy programs.
  • Serve as a preceptor for pharmacy students and/or residents, introducing them to drug utilization management, care management activities, product review, and program development.
Desired Qualifications
  • An advanced degree (e.g., PharmD, MBA, MHA, MPH, or equivalent experience).
  • Managed care setting experience for greater than 5 years.
  • Experience in formulary management, rebate negotiations, and decisions.
  • Experience with Health Benefit Exchanges and in leading Pharmacy and Therapeutic Committees.

Premera Blue Cross is a regional health plan based in Mountlake Terrace, Washington, serving more than 2.8 million people in Alaska and Washington. It provides comprehensive health benefits and a wide range of related services, including health, life, vision, dental, stop-loss, disability, and workforce wellness offerings. Its products are delivered through employer groups, individuals, and other customers, with a focus on tailored services, quality outcomes, and cost control to make healthcare work better for customers. Premera differentiates itself by operating as an Independent Licensee of the Blue Cross Blue Shield Association in its Pacific Northwest footprint, offering a broad benefits portfolio and services such as language assistance and accessible support to meet civil rights and customer needs. The company’s goal is to improve customers’ lives by making healthcare easier to access, understand, and manage, while maintaining affordable, quality care.

Company Size

1,001-5,000

Company Stage

N/A

Total Funding

N/A

Headquarters

Mountlake Terrace, Washington

Founded

1933

Simplify Jobs

Simplify's Take

What believers are saying

  • Matchmaker served 2,700 members in 2024, up from 800 in 2023.
  • Dr. Rushika Fernandopulle joined board in September 2024 for innovation.
  • UAA partnership expands social worker pipeline since 2022 investment.

What critics are saying

  • MultiCare termination forces member provider switches to competitors.
  • 30% Matchmaker lists fail to secure appointments due to shortages.
  • UAA investments yield no clinician supply increases by 2026.

What makes Premera Blue Cross unique

  • Matchmaker for Behavioral Health launched in 2023 curates in-network providers.
  • $1.4 million UW Medicine grant integrates care in three Black community clinics.
  • 22% behavioral health network expansion adds over 1,000 clinicians since 2021.

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Benefits

Health Insurance

Dental Insurance

Vision Insurance

Life Insurance

Disability Insurance

401(k) Company Match

Wellness Program

Unlimited Paid Time Off

Paid Vacation

Tuition Reimbursement

Commuter Benefits

Hybrid Work Options

Company News

Spokane Journal of Business
Feb 27th, 2025
Premera's mental health matchmaker service grows

Premera Blue Cross, which is headquartered in Mountlake Terrace, Washington, launched its matchmaker for behavioral health program in 2023 to reduce barriers for people experiencing mental health conditions and substance abuse disorders.

PR Newswire
Sep 16th, 2024
Premera Appoints Dr. Rushika Fernandopulle to Board of Directors

MOUNTLAKE TERRACE, Wash., Sept. 16, 2024 /PRNewswire/ - Premera today announced Dr. Rushika Fernandopulle has joined its Board of Directors.

Free Press Publishing
May 13th, 2024
Premera plans to drop MultiCare

MEDICAL LAKE - Premera Blue Cross has announced the potential termination of its coverage agreement with MultiCare, a prominent healthcare provider in Washington State.

Mountlake Terrace
May 3rd, 2024
Premera hires Dr. Romilla Batra as new chief medical officer

Premera hires dr. Romilla Batra as new chief medical officer.

PR Newswire
Jan 30th, 2024
Premera Blue Cross, Uw Medicine Collaborate On Behavioral Health Integration For Black Communities

Grant helps three clinics in western Washington implement evidence-based Collaborative CareMOUNTLAKE TERRACE, Wash., Jan. 30, 2024 /PRNewswire/ -- Premera Blue Cross, a health plan in the Pacific Northwest, today announced the company's efforts with the AIMS Center at the University of Washington School of Medicine to improve mental health outcomes for Black and African American communities. Through a $1.4 million investment, three clinics in western Washington will receive funds to implement Collaborative Care, a specific model of integrated care developed at UW Medicine to treat common conditions like depression and anxiety.The Centers for Disease Control and Prevention found that Black adults had equal or higher rates of depression as white adults, yet studies show only 25 percent of Black Americans seek mental health care, compared to 40 percent of white Americans. Through Collaborative Care, patients can receive care for their mental health in the same setting they are treated for their physical health. This can help break down barriers to seeking care and reduce disparities in mental health outcomes.The clinics selected to receive funds are in areas of western Washington where a higher proportion of Black and African American people live. They include:Northwest Medical Specialties in TacomaNorthwest Medical Specialties in Federal WayHopeCentral pediatrics clinic in south Seattle"It can be difficult for anyone to find an available mental health provider, but we know there are additional, long-standing barriers Black and African American communities face when seeking care," said Kitti Cramer, executive vice president at Premera Blue Cross

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