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Highmark Blue Cross Blue Shield Managed Care Pharmacy Residency Program Program Description: The Managed Care Residency at Highmark will provide a unique environment that grants exposure to a multifaceted approach to managed care pharmacy, including clinical management, sales, operations, and scholarly activities. The resident will be an integral part of the clinical team and will participate in virtually all of the daily clinical activities and operations as the full-time pharmacists, such as performing clinical reviews, policy writing, formulary updates, and Medication Therapy Management for Medicare Part D. Furthermore, the resident will be expected to present professional posters at a national meeting of managed care organizations and/or publish articles in peer-reviewed professional journals. Required and elective rotations will provide the resident with exposure to diverse experiences such as specialty pharmacy, sales and marketing, regulatory and compliance, contracting and manufacturer relations, Senior Products, journal clubs, new drug presentations, direct patient care, and various teaching opportunities. Objectives: Develop a detailed understanding of the managed care business and the potential roles of pharmacists within the managed care setting. Gain an understanding of prescription drug benefit design, including an understanding of the formulary process and components of different types of formularies (open, closed, multi-tiered). Develop exceptional written and verbal communication skills, demonstrated through daily professional interactions; preparing provider, member, and group communications; oral presentations; poster presentations; and/or article publication. Demonstrate an ability to perform an evaluation of both a new medication as well as a class review based on efficacy, safety, unique value, and cost parameters utilizing drug information skills. Develop criteria used to evaluate a request for non-formulary drug coverage, evaluate a prior authorization request, or evaluate a managed prescription drug coverage request. Participate in the clinical evaluation process for determining whether coverage for non-formulary medications and/or prior authorizations will be approved. Gain an understanding of regulatory and legislative issues impacting the health care industry with a focus on managed care. Gain an understanding of the benefit consultant’s role in evaluating trends in current benefit structures and opportunities for managing benefits. Rotations: Drug Utilization Review/Pharmaceutical Management Medication Therapy Management Formulary Monograph and Policy Development Member, Group, and Provider Communications Specialty Pharmacy Contracting Pipeline Management Medicare Part D file management Provider detailing Sales and Marketing Other opportunities identified jointly by the resident and Highmark Case Management/Medical Policy Contact Information: Prospective candidates should forward curriculum vitae and letter of intent (detailing experience, background, reason for pursuing a managed care residency, and career goals) to: Eric Culley, PharmD Manager of Clinical Pharmacy Services Highmark Blue Cross Blue Shield 120 Fifth Avenue, Ste 1812 Pittsburgh, PA 15222 In addition, 3 letters of recommendation will be required at the time of interview. Interview Process: Interviews are tentatively scheduled to begin in late January. Please note that Highmark is participating in the Resident Matching Program.