About this role
Your Role
The Pharmacy team provides pharmacy benefit management services and strategies to support Blue Shield affordability and membership goals. The Pharmacist, Principal of Pharmacy Line of Business (LOB) Management will report to the Sr. Manager, Pharmacy LOB Management. In this role, you will support end-to-end pharmacy performance and the development and implementation of current and pipeline pharmacy strategies, including pharmacy product strategy and pharmacy benefit design, to advance pricing, membership growth, and retention objectives.
Our leadership model is about developing great leaders at all levels and creating opportunities for our people to grow – personally, professionally, and financially. We are looking for leaders that are energized by creative and critical thinking, building and sustaining high-performing teams, getting results the right way, and fostering continuous learning.
Your Work
In this role, you will
- Develop, analyze & monitor prescription drug, medical claims, and program data to identify opportunities to improve quality and cost of healthcare and to monitor/report performance and outcomes
- Develop project proposals for identified opportunities and support implementation
- Serve as a BSC Pharmacy Services contact and subject matter expert to stakeholders, and manage external relationships (vendors, clients) related to assigned work
- Serve as a primary pharmacy lead to work with Medicare and/or Commercial business units to develop and implement pharmacy products and market initiatives that align with business unit growth and profitability objectives
- Lead and/or actively participate in cross functional processes, including executive audience forums, to brainstorm, influence and recommend pharmacy strategies and initiatives to support value proposition, annual go to market and multi-year roadmap planning
- Provide thought leadership and pharmacy marketplace intelligence to influence product and cost of health care strategy development and prioritization
- Monitor pharmacy program performance, marketplace and mandate requirements, and work cross functionally and coordinate with other business units such as Actuary and Product to support line of business management and develop solutions to differentiate Blue Shield of California
- Support issue resolutions, communications, and solutions development that impact pharmacy benefit and day-to-day operations to ensure lines of business deliverables are met
- Support Pharmacy Care Reimagined strategic initiative implementation as appropriate
- Perform other duties as assigned
Your Knowledge and Experience
- Requires a Doctor of Pharmacy (PharmD) degree
- Requires a currently active and unrestricted California Registered Pharmacist (RPh) license
- Requires 4 years of experience in clinical pharmacy
- Experience working in a managed care or pharmacy benefit management setting is preferred
- Prior experience in presenting pharmacy program recommendations, performance, value and observations to executive leadership is preferred
- Prior experience in pharmacy benefit strategy and solutions development with understanding of pharmacy levers and marketplace requirements is preferred
- Excellent presentation, verbal and written skills with ability to understand and convey complex ideas to audience with diverse backgrounds
- Strong business acumen with proven experience in strategy development and planning
- Proficiency in MS Office products, particularly in MS Word, PowerPoint, and Excel
Hybrid
This role requires employees to be in-office based on our hybrid workplace model, balancing purposeful in-person collaboration with flexibility. For most teams, this means coming into the office two days each week.
Employees living more than 50 miles from an office location will work with their manager to determine in-office time based on business need.