Pharmacy Customer Service Representative

Transformation is the opportunity

Blue Shield of California is the third largest health plan in California, with about $7.5 billion in revenue. Our mission is to ensure Californian's access to high-quality health care at a reasonable price.

Join Blue Shield of California and grow your career with a leader that’s stirring up a change.


Embark on a new career path that expands your knowledge of Pharmacy Benefit Management. Blue Shield of California is seeking a Pharmacy Technician to work in our fast-paced Pharmacy Services Call Center in Downtown San Francisco.
This Pharmacy Technician will be responsible for answering inquiries regarding pharmacy benefits of our members, including coverage inclusions and exclusions. The technician will assist in providing formulary alternatives. Will also coordinate, assist in and support implementation of procedures and guidelines for the drug prior authorization program for the outpatient Pharmacy Benefit.

Communicates with the physician, physician's office staff, medical management and other Blue Shield team members to assist with accurate and efficient resolution of prior authorization requests.

Assists in providing formulary alternatives and communicates prior authorization criteria, and discusses pharmacy benefit coverage inclusions/exclusions when required.

Works independently and as part of a team interfacing in a courteous and professional manner with physicians, physician office staff, retail pharmacy staff, patients, and other health care professionals regarding pharmacy benefit management.

Provides drug usage history and other pertinent pharmacy benefit related computer searches for pharmacists and Medical Director to assist in case specific reviews and drug evaluations.

Assists pharmacists with drug utilization review programs, NCQA QI programs or other assigned projects.

Communicates prior authorization criteria, pharmacy benefit coverage and formulary alternatives to physician, physician office staff, medical management staff, sales, and member services.

Assists in research and resolution of physician inquiries and grievances. Provides essential clinical information to BSC Member Services, Administrative Review Department and Consumer Affairs to resolve Member inquires and grievances.

Associate's degree and one year pharmacy related experience and/or training; or equivalent combination of education and experience. State Board of Pharmacy Technician certification required.

Ability to use pharmacy computer system and Pharmacy Benefit Management (PBM) system and complete tasks according to the Department's standards.

Ability to respond to common inquiries or complaints from customers, regulatory agencies or members of the business community.



Proficient in the use of computers and related software applications.

Familiarity with pharmacy programs and evaluating appropriate drug use.

This job requires the ability to work in a multi-tasking, windows based computer environment.

Blue Shield of California is an Equal Opportunity Employer.


Our comprehensive benefits begin on your first day with medical, dental and vision coverage; 20 days PTO annually; 9 paid holidays; matching 401(k); and company pension.

Blue Shield of California is an Equal Opportunity Employer.

An Independent Member of the Blue Shield Association.

Blue Shield of California

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