Anyone working at BCBS? as a pbm clinical pharmacist?

[Niceguy90]

I have an Interview with BCBS as a clinical pharmacist, Does anyone knows what to expect in the interview?

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[quickpic007]

how did you get this interview

 

[abrahamdrinkin]

What is the job description?

Also, BCBS usually isn't a PBM

 

[Niceguy90]

how did you get this interview

applied on the company web-site , got a call few days ago.

 

[Niceguy90]

What is the job description?

Also, BCBS usually isn't a PBM

Yes! my bad.

 

[abrahamdrinkin]

BCBS pharmacist could be doing any number of things. If you can say what kind/what the job description is, I will tell you how to prepare.

 

[PikminOC]

Denying prior authorization..

 

[Niceguy90]

BCBS pharmacist could be doing any number of things. If you can say what kind/what the job description is, I will tell you how to prepare.

Thank you!!!, the exact job is no longer showing up on their website but I have taken notes, they are

Overview-

*involve in clinical coverage review
*prevent fraud and waste
*Review therapies with physician, also responsible for educating doctors and influencing their prescribing habits to reduce the insurance payout,develop strategy to modify prescribing habits
*develop and enforce DURs
*communicate effectively regarding pharmacotherapeutic issues.
*serve as liaison to the Policy Department and assist with development of policy as it applies drugs.

Essential Duties-

• involve in clinical coverage review of medication including preventing abuse waste, make and enforce DURs
• Provide effective and efficient communication of pharmacotherapy issues.
• Develop and enforce various behavior modification principles to influence doctors to prescribe appropriately.
• Identify target doctors, establish credibility and utilize both verbal and written communications to modify behavior.
• Serve as the main clinical support professional for researching prescription drug inquiries.
• Develop, implement and periodically update doctor and patient educational documents.
• help with Drug Formulary development, management and publishing of documents and online Drug Lists and other pharmacy materials and support BCBS P & T Committee.
• act as liaison to medical Policy helping with the development of policy as it applies to drugs.
• involve in clinical and operational process enhancement and cost savings opportunities.
• verify and solve clinical compliance grievances and requests.
• implement Medicare ratings of STAR measures. and Adhere to Policies and Procedures.

 

[npage148]

I interviewed with them about 18 months ago in western ny. Phone interview was standard generic interview questions. In person was just the boss and not very formal. Mostly discussing the duties and if I could see myself coming up to speed with the nature of the work, dealing with the regular schedule (she said people can't deal with not having weekdays off), and the like.

FYI, I didn't get the job, it was filled internally

 

[abrahamdrinkin]

Thank you!!!, the exact job is no longer showing up on their website but I have taken notes, they are

Overview-

*involve in clinical coverage review
*prevent fraud and waste
*Review therapies with physician, also responsible for educating doctors and influencing their prescribing habits to reduce the insurance payout,develop strategy to modify prescribing habits
*develop and enforce DURs
*communicate effectively regarding pharmacotherapeutic issues.
*serve as liaison to the Policy Department and assist with development of policy as it applies drugs.

Essential Duties-

• involve in clinical coverage review of medication including preventing abuse waste, make and enforce DURs
• Provide effective and efficient communication of pharmacotherapy issues.
• Develop and enforce various behavior modification principles to influence doctors to prescribe appropriately.
• Identify target doctors, establish credibility and utilize both verbal and written communications to modify behavior.
• Serve as the main clinical support professional for researching prescription drug inquiries.
• Develop, implement and periodically update doctor and patient educational documents.
• help with Drug Formulary development, management and publishing of documents and online Drug Lists and other pharmacy materials and support BCBS P & T Committee.
• act as liaison to medical Policy helping with the development of policy as it applies to drugs.
• involve in clinical and operational process enhancement and cost savings opportunities.
• verify and solve clinical compliance grievances and requests.
• implement Medicare ratings of STAR measures. and Adhere to Policies and Procedures.

Okay so this doesn't sound like you would actually be doing the PAs, more like making the criteria for PAs, utilization guiedelines, maybe some physician resources materials.

This also sounds like it is Medicare possibly, based on the STARs mention and the word grievances. If it is Medicare, go read Chapter 6 and chapter 18 of the Medicare Part D Plan manual.
https://www.cms.gov/Medicare/Prescr...ownloads/Part-D-Benefits-Manual-Chapter-6.pdf

Medicare Prescription Drug Appeals & Grievances - Centers for Medicare & Medicaid Services

Also, I would go read true Technical Notes on the Part D Star ratings that are available on CMS's website.
Maybe read the Beers list of High Risk Meds.

If it's not Medicare specific, none of that would help you.

My next piece of advice is to look up situational interviewing and thing of specific stories with specific endings/results.

I got asked things like "Tell me a time when you performed drug utilization review activities," which I had no idea how to answer, but basically you need stories about how you redirected care to more appropriate or cost-effective options based on clinical reasoning (not just that the patient couldn't afford it).

Stories about researching patients with literature searches are always good.

As far as helping with formulary, it would be a lot of evaluating new products. Usually when new products are approved, you have the package insert and the study that got it approved. Pretend you love learning that stuff.

Good luck!
PM me if you have any questions.
Let us know if you get it.

 

[Niceguy90]

Okay so this doesn't sound like you would actually be doing the PAs, more like making the criteria for PAs, utilization guiedelines, maybe some physician resources materials.

This also sounds like it is Medicare possibly, based on the STARs mention and the word grievances. If it is Medicare, go read Chapter 6 and chapter 18 of the Medicare Part D Plan manual.
https://www.cms.gov/Medicare/Prescr...ownloads/Part-D-Benefits-Manual-Chapter-6.pdf

Medicare Prescription Drug Appeals & Grievances - Centers for Medicare & Medicaid Services

Also, I would go read true Technical Notes on the Part D Star ratings that are available on CMS's website.
Maybe read the Beers list of High Risk Meds.

If it's not Medicare specific, none of that would help you.

My next piece of advice is to look up situational interviewing and thing of specific stories with specific endings/results.

I got asked things like "Tell me a time when you performed drug utilization review activities," which I had no idea how to answer, but basically you need stories about how you redirected care to more appropriate or cost-effective options based on clinical reasoning (not just that the patient couldn't afford it).

Stories about researching patients with literature searches are always good.

As far as helping with formulary, it would be a lot of evaluating new products. Usually when new products are approved, you have the package insert and the study that got it approved. Pretend you love learning that stuff.

Good luck!
PM me if you have any questions.
Let us know if you get it.

Awesome!!! This really helps, I was looking into situation scenario questions and how to answer them, and going over my resume and thinking over some things they might ask.I do remember mentioning of "Medicare and senior services" some where on top of the job description page but it wasn't mentioned in the Essential duties, I will definitely go through that part -d pdf. Thank you very much and I will sure update this post after the interview!

 

[Niceguy90]

I interviewed with them about 18 months ago in western ny. Phone interview was standard generic interview questions. In person was just the boss and not very formal. Mostly discussing the duties and if I could see myself coming up to speed with the nature of the work, dealing with the regular schedule (she said people can't deal with not having weekdays off), and the like.

FYI, I didn't get the job, it was filled internally

I have had some interviews before which were filled by internal candidate, where it felt like they already had a candidate in mind, but Still interviewed me.(may be because they had some formalities to follow to interview certain candidates before choosing the one they had in mind,that sucks!)

 

[Fluffhead.D]

I interviewed with them about 18 months ago in western ny. Phone interview was standard generic interview questions. In person was just the boss and not very formal. Mostly discussing the duties and if I could see myself coming up to speed with the nature of the work, dealing with the regular schedule (she said people can't deal with not having weekdays off), and the like.

FYI, I didn't get the job, it was filled internally

“Filled internally” is the story of my life. Sorry to hear, good luck