Job DescriptionYour 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.
ResponsibilitiesYour 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
QualificationsYour 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
HybridThis 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.
About the TeamAbout Blue Shield of CaliforniaAs of January 2025, Blue Shield of California became a subsidiary of Ascendiun. Ascendiun is a nonprofit corporate entity that is the parent to a family of organizations including Blue Shield of California and its subsidiary, Blue Shield of California Promise Health Plan; Altais, a clinical services company; and Stellarus, a company designed to scale healthcare solutions. Together, these organizations are referred to as the Ascendiun Family of Companies.
Our Values: - Honest. We hold ourselves to the highest ethical and integrity standards. We build trust by doing what we say we're going to do and by acknowledging and correcting where we fall short.
- Human. We strive to listen and communicate effectively, showing empathy by understanding others' perspectives.
- Courageous. We stand up for what we believe in and are committed to the hard work necessary to achieve our ambitious goals.
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.
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