Job Description

Your Role

The Cost of Health Care (COHC) & Specialty Drug Management Pharmacy team is responsible for managing the Specialty Drug strategies across the pharmacy and medical benefit and leading and implementing cost of health care initiatives. The Pharmacist, Principal will report to the Director, Pharmacy COHC & Specialty Drug Management. In this role you will be responsible for oversight of the specialty pharmacy networks, limited distribution drug access, specialty-at-retail initiatives, direct drug distribution partnerships, and specialty pharmacy programs to improve affordability, access, quality, and member experience.

Responsibilities

Your Work
In this role, you will:

• Lead end-to-end specialty drug program strategy across pharmacy and medical benefit
• Manage specialty pharmacy, LDD, specialty-at-retail, and direct contracted distribution networks
• Monitor network performance, utilization, reimbursement, access, service levels, and financial outcomes
• Develop and oversee specialty pharmacy programs such as short fill, biosimilar, site-of-care, and affordability initiatives
• Partner with internal teams, vendors, manufacturers, and pharmacy networks to execute strategic initiatives
• Use analytics to evaluate specialty drug trends, measure program effectiveness, and present recommendations to leadership

Qualifications

Your Knowledge and Experience

• Requires a Doctor of Pharmacy (PharmD) degree from an accredited school of pharmacy in the U.S.
• Requires a current, active, and unrestricted California Registered Pharmacist (RPh) license
• Requires 4 years of experience in clinical pharmacy
• Experience in specialty pharmacy, managed care pharmacy, pharmacy benefit design, specialty networks, LDD programs, and biosimilar strategies
• Prior experience in evaluation of pharmacy program value and performance drivers
• Prior management experience in health plans or pharmacy benefit management companies, with deep knowledge of pharmacy benefit, formulary and network products, program strategies and competitive landscape
• Prior experience in vendor partnership, contract operations, negotiations, and performance management is preferred
• Possesses strong business acumen with proven experience in pharmacy strategy development and planning
• Strong knowledge of specialty drug reimbursement, contracting, distribution models, analytics, and vendor management
• Excellent communication skills with prior experience in presentations to internal and external executive level business stakeholders
• Demonstrated leadership, strategic planning, financial analysis, and cross-functional collaboration skills
• Detail-oriented with the ability to work in a fast-paced environment
• Exhibit "can do" attitude and solution-oriented approach to resolve challenges

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.

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.