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Clinical Pharmacist, Medicare Clinical Programs

Blue Cross and Blue Shield of Massachusetts, Inc.
vision insurance, paid time off, 401(k)
United States, Massachusetts, Hingham
Nov 18, 2025
Ready to help us transform healthcare? Bring your true colors to blue.

The Role

The Clinical Pharmacist, Medicare Clinical Programs is responsible for providing comprehensive medication management services to improve patient outcomes. The pharmacist will also support care management with identifying and resolving drug-related problems for Medicare members. The Clinical Pharmacist will assist the Pharmacy Department in the measurement of program objectives and outcomes. This role will also be responsible for ongoing education of internal teams on various pharmacy-related topics, including Stars. The primary functions include supporting actionable pharmacy strategies that are clinically appropriate and cost-effective, while providing integrated services in collaboration with case management.

This position is eligible for the flex persona. Local candidates are required to work from the Hingham office 2X per month.

Key Responsibilities:

  • Communicate telephonically with members to help identify and answer any drug-related questions to support medication adherence.
  • Maintain accurate and detailed records of all medication-related conversations.
  • Provide care management in reviewing and evaluating drug information for adherence, disease specific case management collaboration, medication reconciliation and polypharmacy to identify potential medication therapy problems and recommend appropriate solutions for identified patients.
  • Provide in-service education on pharmacy related topics to care management staff and other associated teams
  • Supports and participates in Medicare Case Management rounds
  • Conduct comprehensive medication reviews for eligible members, including identifying potential drug interactions, side effects, and other risk factors
  • Educate patients about their medications, conditions, and pharmacy benefits to achieve optimal participant care outcomes.
  • Collaborate with Pharmacy Benefit Manager (PBM) clinical team and internal BCBSMA departments to align priorities and execute initiatives
  • Assist in the creation and delivery of presentations and communications for various internal and external projects and meetings
  • Engage and follow-up with providers on identified interventions
  • Special projects as assigned

Key Qualifications:

  • Excellent written and oral communication skills including ability to present to various audiences
  • Excellent communication skills
  • Strong organizational and time management skills, including ability to work independently and prioritize multiple projects and assignments
  • Demonstrates empathy by understanding and sharing members' feelings and perspectives, fostering trust, loyalty, and satisfaction
  • Demonstrated strength in analysis, identification of problems and issue resolution
  • Excellent skills in teamwork and team approaches to goal setting and attainment
  • Demonstrated ability to establish and maintain positive, effective working relationships with staff, internal and external customers
  • Must be results oriented.

Education and Experience:

  • Unrestricted current and valid license to practice pharmacy in the state of Massachusetts
  • Graduate of an ACPE accredited School of Pharmacy with a PharmD or related work experience
  • Minimum of 2-3 years' experience functioning as a clinical pharmacist in a managed care or hospital setting
  • Experience in direct supervision of technical support staff for clinical and/or service and operational programs is desirable.
  • Intermediate to advanced proficiency in standard computational office-suite applications including but not limited to Microsoft Word, Excel and PowerPoint and relational database manipulation is highly preferred especially with recent work-related experience.

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Minimum Education Requirements:

High school degree or equivalent required unless otherwise noted above

LocationHingham Time TypeFull time Salary Range: $115,560.00 - $141,240.00

The job posting range is the lowest to highest salary we in good faith believe we would pay for this role at the time of this posting. We may ultimately pay more or less than the posted range, and the range may be modified in the future. An employee's pay position within the salary range will be based on several factors including, but limited to, relevant education, qualifications, certifications, experience, skills, performance, shift, travel requirements, sales or revenue-based metrics, and business or organizational needs and affordability.

This job is also eligible for variable pay.

We offer comprehensive package of benefits including paid time off, medical/dental/vision insurance, 401(k), and a suite of well-being benefits to eligible employees.

Note: No amount of pay is considered to be wages or compensation until such amount is earned, vested, and determinable. The amount and availability of any bonus, commission, or any other form of compensation that are allocable to a particular employee remains in the Company's sole discretion unless and until paid and may be modified at the Company's sole discretion, consistent with the law.

WHY Blue Cross Blue Shield of MA?

We understand that theconfidence gapandimposter syndromecan prevent amazing candidates coming our way, so please don't hesitate to apply. We'd love to hear from you. You might be just what we need for this role or possibly another one at Blue Cross Blue Shield of MA. The more voices we have represented and amplified in our business, the more we will all thrive, contribute, and be brilliant. We encourage you to bring us your true colors, , your perspectives, and your experiences. It's in our differences that we will remain relentless in our pursuit to transform healthcare for ALL.

As an employer, we are committed to investing in your development and providing the necessary resources to enable your success. Learn how we are dedicated to creating an inclusive and rewarding workplace that promotes excellence and provides opportunities for employees to forge their unique career path by visiting ourCompany Culturepage. If this sounds like something you'd like to be a part of, we'd love to hear from you. You can also join ourTalent Communityto stay "in the know" on all things Blue.

At Blue Cross Blue Shield of Massachusetts, we believe in wellness and that work/life balance is a key part of associate wellbeing. For more information on how we work and support that work/life balance visit our "How We Work" Page.

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