Blue Shield Of California

Program Manager, Consultant- Pharmacy Benefits Management

Blue Shield Of California$90K — $120K *
Pharmaceuticals & Biotech
5 - 7 years of experience
Job Overview by Ladders

Qualifications

  • Bachelor's degree or equivalent experience required
  • 7 years of relevant experience
  • Advanced knowledge of pharmacy operations at the health plan level
  • Excellent analytical and problem-solving skills
  • Interpersonal, verbal, and written communication skills with a solutions-oriented approach
  • Demonstrated leadership and project management experience
  • Proficient in MS Office tools including Excel, PowerPoint, SharePoint, and Project

Responsibilities

  • Ensure compliance and accurate execution of operational functions
  • Manage assigned operational functions with subject matter expertise
  • Lead program activities including requirements gathering and implementation
  • Develop resourcing strategies for project and operational support
  • Facilitate cross-functional meetings and resolve issues through collaboration
  • Assess new pharmacy production stabilization issues and lead intake efforts
  • Oversee and manage resolution activities for assigned pharmacy issues
  • Create action plans detailing root cause analysis and timelines for resolution
  • Distribute executive summary reports to stakeholders for status updates

Benefits

  • Hybrid work environment promoting in-office collaboration and flexibility
  • Opportunity to work with cross-functional teams and external partners
  • Exposure to complex challenges in pharmacy production stabilization
  • Leadership role with significant program management responsibilities
  • Dynamic work environment in a critical healthcare sector
Full Job Description
Job Description

Your Role

The Pharmacy Operations and Stabilization team provides management and end-to-end oversight of all Pharmacy operations, production stabilization issues, and drives issues from identification to resolution within a matrixed environment. The Program Manager, Consultant will report to the Sr Manager, Pharmacy Operations and Stabilization. In this role you will assure timely and accurate operations for your assigned areas, lead intake and initial assessment of new pharmacy issues, partner with subject matter experts to perform root cause analysis, identify impacts and potential solution options, develop and drive the summary and action plan including any remediation needed for medium to large issues impacting Pharmacy Strategy and Operations. Working in a matrixed environment, the Program Manager, Consultant will partner with cross-functional teams and external vendor partners to ensure alignment with stakeholders.

Responsibilities

Your Work

In this role, you will:
  • Assure consistent, accurate, timely and compliance execution of assigned operational functions
  • Provide subject matter expertise and management of assigned operational functions
  • Provide overall program leadership, guidance, and manage all aspects of a given program, including requirements gathering, business case creation, and implementation
  • Develop resourcing strategies to ensure optimum support for projects and for the day-to-day operational activities
  • Lead cross-functional meetings and foster teamwork; drive escalation and resolution of issues, while promoting collaboration and coordination across broad categories of stakeholders
  • Lead intake efforts and perform initial assessment of new medium to large pharmacy production stabilization issues
  • Own, manage, and oversee the end-to-end activities associated with resolving the medium to large pharmacy production stabilization issues assigned to you
  • Develop a summary and action plan including root cause analysis, solution options, remediation efforts, and a timeline for resolution of each pharmacy issue
  • Develop and drive a resolution plan for highly matrixed and complex pharmacy production stabilization issues
  • Develop and distribute executive summary reports to keep key stakeholders informed of status and progress
  • Other duties as assigned


Qualifications

Your Knowledge and Experience
  • Requires a Bachelors degree or equivalent experience
  • 7 years of prior relevant experience required
  • Advanced knowledge of pharmacy operations at the health plan level including benefit build and adjudication and/or claims/financial data exchange
  • Excellent analytical and problem-solving skills
  • Excellent interpersonal, verbal and written communication skills that exhibit a solutions-oriented approach
  • Demonstrated leadership, project management, and executive level reporting experience
  • Experience using MS Office tools including Excel, PowerPoint, SharePoint and Project


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.

About Blue Shield Of California

Blue Shield of California is a not-for-profit health plan provider that has been providing Californians with access to high-quality healthcare for over 80 years. The company offers a range of health insurance products and services to individuals, families, and employers. Blue Shield of California is committed to improving the health and wellbeing of its members and the communities it serves. The company is also committed to sustainability and has implemented a number of initiatives to reduce its environmental impact.
Learn more about Blue Shield Of California
Size
7,000 employees
Industry
Founded
1981

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