Blue Shield of California

Pharmacist, Principal

Blue Shield of California  •  Long Beach, CA (Hybrid)  •  14 hours ago
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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.

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:

  • 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

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.

Blue Shield of California

About Blue Shield of California

Blue Shield of California strives to create a healthcare system worthy of its family and friends that is sustainably affordable. The health plan is a tax paying, nonprofit, independent member of the Blue Shield Association with nearly 6 million members, over 7,500 employees and more than $25 billion in annual revenue.

Founded in 1939 in San Francisco and now headquartered in Oakland, Blue Shield of California and its affiliates provide health, dental, vision, Medicaid and Medicare healthcare service plans in California. The company has contributed more than $60 million to Blue Shield of California Foundation in the last three years to have an impact on California communities.

For more news about Blue Shield of California, please visit news.blueshieldca.com.

Industry
Finance & Insurance
Company Size
5,001-10,000 employees
Headquarters
Oakland, California
Year Founded
1939
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