Job Description

Your Role

The Formulary Strategy and Pharmacy & Therapeutics team is responsible for formulary development, clinical evaluation of drugs, and support of the Pharmacy & Therapeutics (P&T) process to advance clinically appropriate, evidence-based, and cost-effective drug management strategies. The Pharmacist, Principal will report to the Senior Manager of Pharmacy & Therapeutics. In this role, you will lead development of drug and therapeutic class reviews by evaluating clinical evidence, guidelines, comparative effectiveness, and budget impact data to support formulary decision making. You will also collaborate with cross-functional stakeholders to develop pharmacoeconomic and value-based assessments that support Blue Shield of California's formulary strategy and mission.

Responsibilities

Your Work

In this role, you will:

• Facilitate formulary development and provide P&T clinical support based on scientific evidence and standards of practice, including assessment of peer-reviewed literature, pharmacoeconomic studies, outcomes research, comparative effectiveness research, and budget impact analyses.
• Collaborate with analytics and cross-functional partners to develop pharmacoeconomic analyses, outcomes research, and recommendations that support cost-effective formulary management.
• Develop and analyze prescription drug and medical claims data reports to identify opportunities to improve quality and promote cost-effective use of medications.
• Regularly assess medical evidence to support appropriate medication use through the annual medication review process.
• Partner with management and cross-functional teams to support development and implementation of value-based formulary design, including enhancements to P&T processes that enable value-based decisions.
• Prepare client-facing clinical summaries, supporting documentation, and reports, and communicate clinical value propositions across therapeutic areas.
• Perform retrospective data analysis and healthcare cost analysis to support formulary decisions, formulary maintenance, and management of total cost of care.
• Conduct presentations at formulary meetings, Pharmacy & Therapeutics committees, and drug utilization review meetings.
• Work independently and collaboratively with multidisciplinary teams with minimal oversight and direction.

Qualifications

Your Knowledge and Experience

• Requires a Doctor of Pharmacy (PharmD) degree.
• Requires an active California Registered Pharmacy (RPh) license in good standing.
• Requires 4 years of experience in clinical pharmacy.
• Requires experience working in a managed care setting and direct client and provider interface.
• Demonstrated leadership skills and capabilities.
• Thorough clinical knowledge regarding the therapeutic use of drugs.
• Excellent oral and written communication skills, including presentation skills.
• Strong problem-solving, analytical, and project or program management skills.
• Ability to work independently and as part of a team, including in a hybrid environment.
• Proficiency with Microsoft Office applications.

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.

Our Workplace Model

We believe in fostering a workplace environment that balances purposeful in-person collaboration with flexibility - providing clear expectations while respecting the diverse needs of our workforce. Our workplace model is designed around intentional in-person interaction, collaboration, connection, creativity and flexibility:

• For most teams, this means coming into the office two days per week.
• Employees living more than 50 miles from an office location, out of state employees, and employees in certain member-facing roles should work with their manager to determine in-office time based on business need.
• For employees with medical conditions that may impact their ability to work in-office, we are committed to engaging in an interactive process and providing reasonable accommodations to ensure their work environment is conducive to their success and well-being.

The Company reserves the right to require more presence in the office based on business needs, and requirements are subject to change with periodic reviews.

Physical Requirements:

Office Environment - roles involving part to full time schedule in Office Environment. Based in our physical offices and work from home office/deskwork - Activity level: Sedentary, frequency most of work day.

Please click here for further physical requirement detail.