Blue Cross Blue Shield of North Carolina

Sr Clinical Pharmacist

Healthcare
8 - 10 years of experience
Job Overview by Ladders

Qualifications

  • Doctor of Pharmacy (PharmD) degree or 10+ years of relevant experience instead of a degree.
  • Active pharmacist license in North Carolina or ability to obtain licensure before hiring.
  • 5+ years of experience in managed care, health plan, PBM, or employer pharmacy consulting preferred.
  • Experience leading large employer or public-sector pharmacy initiatives preferred.
  • Strong skills in formulary management and clinical program development.

Responsibilities

  • Serve as the strategic clinical pharmacy lead and advisor for a large employer client.
  • Develop pharmacy benefit strategies focusing on clinical outcomes and total cost of care.
  • Collaborate with internal and client leadership on aligning pharmacy strategies with business objectives.
  • Lead client-facing meetings and executive presentations related to pharmacy benefit strategies.
  • Evaluate pharmacy trends and utilization patterns to optimize programs and outcomes.
  • Provide oversight for formulary management and evidence-based coverage strategies.
  • Partner with financial teams to explore rebate strategies that meet client goals.

Benefits

  • Opportunity to work at the cutting edge of healthcare delivery.
  • Work-life balance with flexibility and autonomy.
  • Medical, dental, and vision coverage with wellness programs.
  • Support for parental leave, adoption, and surrogacy.
  • Career development programs and tuition reimbursement available.
  • 401k match with an annual company contribution.
Full Job Description

Job Description

We are hiring for a Senior Clinical Pharmacist! This individual will serve as the strategic clinical pharmacy lead and primary pharmacy advisor for a large employer client. You will be responsible for developing, communicating, and executing pharmacy benefit strategies that optimize clinical outcomes, member experience, and total cost of care. You will also acts as the primary clinical liaison between Blue Cross NC and client stakeholders, providing leadership across formulary management, utilization management, clinical programs, rebate strategy, and pharmacy operations. Also, this individual will partner closely with internal pharmacy, medical, finance, analytics, operations, and account management teams to ensure successful delivery of pharmacy benefit solutions and achievement of client objectives.

What You'll Do

  • Serve as the strategic clinical pharmacy lead and trusted advisor for a large employer client, providing consultation and recommendations on pharmacy benefit strategy and performance.
  • Develop and communicate pharmacy benefit strategies related to formulary design, utilization management, specialty pharmacy, clinical programs, and emerging drug trends.
  • Collaborate with client leadership and internal stakeholders to align pharmacy strategies with business objectives, affordability goals, and member health outcomes.
  • Lead and support client-facing meetings, quarterly business reviews, strategic planning sessions, and executive presentations.
  • Evaluate pharmacy trend drivers, utilization patterns, pipeline therapies, and market developments to identify opportunities for program optimization.
  • Provide clinical leadership and oversight for formulary management initiatives, utilization management programs, and evidence-based coverage strategies.
  • Partner with rebate and financial teams to evaluate manufacturer contracting opportunities and rebate strategies that support client objectives.
  • Support the development, implementation, and monitoring of clinical programs including specialty pharmacy management, site-of-care optimization, preventive medication strategies, and drug utilization initiatives.
  • Collaborate with pharmacy operations teams to ensure successful implementation and ongoing management of pharmacy benefit programs.
  • Analyze and present clinical and financial performance metrics, identifying emerging risks, opportunities, and recommended actions.
  • Ensure compliance with applicable regulatory, accreditation, and quality requirements related to pharmacy benefits.
  • Serve as a subject matter expert for internal business partners, sales teams, account management teams, and executive leadership.
  • Maintain awareness of industry trends, emerging therapies, regulatory developments, and innovative pharmacy benefit solutions.

What You Bring

  • Doctor of Pharmacy (PharmD) degree
  • In lieu of degree, 10+ years of experience in related field.
  • Active pharmacist license in North Carolina or ability to obtain licensure prior to hire.

Bonus Points(Preferred Qualifications)

  • 5+ years of managed care, health plan, PBM, or employer pharmacy consulting experience.
  • Experience serving as a dedicated clinical lead for a large employer, government, or public-sector client.
  • Proven experience leading complex pharmacy initiatives involving multiple stakeholders and cross-functional teams.
  • 9Demonstrated experience presenting and consulting with executive-level clients and external stakeholders.
  • Strong experience with formulary management, utilization management strategy, pharmacy trend management, and clinical program development.
  • Experience with rebate strategy, manufacturer contracting concepts, and pharmacy financial management preferred.
  • Working knowledge of pharmacy operations, specialty pharmacy, and pharmacy benefit administration preferred.
  • Excellent communication, relationship management, presentation, and influencing skills.
  • Strong preference for candidates residing in or willing to relocate to the Raleigh-Durham area to support ongoing client engagement and partnership activities.

WhatYoullGet

  • The opportunity to work at thecutting edgeof health care delivery with a teamthatsdeeply invested in the community
  • Work-life balance, flexibility, and the autonomy to dogreat work
  • Medical, dental, and vision coverage along withnumeroushealth and wellness programs
  • Parental leave and support plus adoption and surrogacyassistance
  • Career development programs and tuition reimbursement for continued education
  • 401k match including an annual company contribution

Salary Range

At Blue Cross NC, we take great pride in a fair and equitable compensation package that reflects market-price and our starting salaries are typically planned near the middle of the range listed. Compensation decisions are driven by factors including experience and training, specialized skill sets, licensure and certifications and other business and organizational needs.Our base salary is part of a robust Total Rewards package that includes an Annual Incentive Bonus*, 401(k) with employer match, Paid Time Off (PTO), and competitive health benefits and wellness programs.

*Based on annual corporate goal achievement and individual performance.

$118,691.00 - $189,906.00

Skills

Clinical Knowledge, Clinical Pharmacy, Clinical Practice Management, Clinical Programs, Clinical Review, Clinical Trials Operations, Medicare, Medicare Part D, Medication Therapy Management, Nursing Practice, Patient Care Coordination, Pharmaceutical Medical Affairs, Pharmacy, Pharmacy Compliance, Pharmacy Management, Pharmacy Operations

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About Blue Cross Blue Shield of North Carolina

Blue Cross Blue Shield of North Carolina (BCBSNC) is a non-profit health insurance company based in Durham, North Carolina. The company provides health insurance to more than 3.7 million customers in North Carolina. BCBSNC offers a variety of health insurance plans, including individual and family plans, Medicare Advantage plans, and employer-sponsored plans. The company also offers wellness programs and resources to help customers manage their health. BCBSNC was founded in 1933 and has since grown to become one of the largest health insurance providers in North Carolina.
Learn more about Blue Cross Blue Shield of North Carolina
Size
5,000 employees
Industry

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