About the role
- Leads the overall management and strategic direction for the pharmacy program including Medicare Part D/EGWP program.
- Identifying new opportunities for optimal drug benefit control, analyzing utilization and pricing across medical and pharmacy benefits, developing tools to manage drug expenditure while maintaining clinical excellence, and presenting recommendations to senior leadership.
- Manages the pipeline, assessing the potential impact on the formulary and medical drug benefit, strategizing manufacturer engagement before and after product launch, and overseeing internal processes for Pharmacy and Therapeutics Committee and the National Pharmacy & Therapeutics meeting preparations, execution, and formulary status decisions.
- Lead internal & external presentations for national forums, Operations Conferences and Plan level presentations.
- Work collaboratively with key stakeholders to identify best practices for management of the drugs under the Medical Benefit. Work cross-functionally to determine process implications of suggested new programs and the operational implementation of initiatives under the medical benefit.
- Lead and manage a team with the aim of driving effective performance management, fostering professional growth, and creating a positive and inclusive work environment. This role is dedicated to utilizing strong leadership and communication skills to motivate and inspire team members, ensuring they are aligned with and committed to achieving the organization’s goals.
The posting range for this position is:
$172,326.00-$263,764.92
Qualifications:
Education
- Required Bachelor's Degree in pharmacy
- Required Doctor of Pharmacy
- Preferred Master's Degree Clinical advanced degree (various fields)Advanced degree in Business (MBA)
Experience
- Required 12+ Years experience in Managed Care Pharmacy or Pharmacy Benefit Management (PBM) experience with an emphasis on Specialty drug management
Knowledge Skills and Abilities
- Solid communication skills
- Strong Interpersonal skills
- Proven proficiency with applicable information technologies
- Analytical skills: ability to perform financial analysis on new products and services as well as basic SWOT analysis
Certifications & Licenses
- Required: PHARMD - Licensed Pharmacist - Various
- Extra Posting Information:
Experience in Managed Care Pharmacy or Pharmacy Benefit Management (PBM) experience with an emphasis on Specialty drug management.
Experience in a senior leadership role.
#LI-Hybrid
The posted salary 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 hiring range and this hiring range may also be modified in the future. A candidate’s position within the hiring range may be based on several factors including, but not limited to, specific competencies, relevant education, qualifications, certifications, relevant experience, skills, seniority, performance, shift, travel requirements, and business or organizational needs. This job is also eligible for annual bonus incentive pay.
We offer a comprehensive package of benefits including paid time off, 11 holidays, medical/dental/vision insurance, generous 401(k) matching, lifestyle spending account and many other 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.
Aplyr's read
Blue Cross Blue Shield is a collective of independent health insurers, ideal for professionals passionate about community health and complex regulatory environments.
What's promising
- •BCBSA offers diverse roles in policy, data science, and healthcare solutions.
- •Strong focus on community-based health initiatives and local operations.
- •Opportunities to work on advanced projects in AI and cybersecurity.
What to watch
- •Complex organizational structure with 36 independent entities may lead to bureaucratic challenges.
- •Navigating regulatory environments can be demanding and intricate.
- •Limited public information about internal culture and employee satisfaction.
Why Blue Cross Blue Shield
- •Federation model allows for localized decision-making and community engagement.
- •Significant involvement in federal and state healthcare policy development.
- •Pioneering roles in healthcare data science and artificial intelligence.
Aplyr’s read is generated by AI from public sources. Was it useful?
About Blue Cross Blue Shield
The Blue Cross Blue Shield Association (BCBSA) is a federation of 36 independent, community-based and locally operated Blue Cross and Blue Shield companies. It provides health insurance coverage to millions of Americans.
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