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.

Our leadership model is about developing great leaders at all levels and creating opportunities for our people to grow – personally, professionally, and financially. We are looking for leaders that are energized by creative and critical thinking, building and sustaining high-performing teams, getting results the right way, and fostering continuous learning.

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.

Your Knowledge and Experience

• Requires a Doctor of Pharmacy (PharmD) degree.

• Requires an active California Registered Pharmacist (RPh) license in good standing.

• Requires 4 years of experience in clinical pharmacy.

• Experience working in a managed care setting and direct client and provider interface is preferred.

• 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 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.