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 Program Manager, Principal will report to the Director, Pharmacy COHC & Specialty Drug Management. In this role you will be responsible for coordinating COHC operations, supporting cross-functional pharmacy affordability forums, and driving implementation of selected pharmacy initiatives that advance trend, savings, quality, and operational performance objectives. This role partners closely with pharmacy leadership, analytics, lines of business, product, actuarial, network, clinical, and COHC governance stakeholders to maintain a clear initiative roadmap, monitor program performance, and ensure timely execution of priority work.

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 COHC operations support, including tracking of pharmacy affordability initiatives, coordination of initiative status updates, and follow-through on operational deliverables
• Coordinate COHC forums, including agenda development, stakeholder preparation, meeting facilitation support, action item tracking, and alignment with related governance and line-of-business forums
• Organize stakeholder deep dives on material trend drivers, emerging pharmacy opportunities, medical and pharmacy benefit drug initiatives, and priority affordability topics requiring cross-functional input
• Develop, maintain, and distribute COHC program performance reporting, including initiative performance, savings versus plan, trend drivers, biosimilar adoption, implementation milestones, risks, and executive-ready summaries
• Support implementation of key COHC pharmacy initiatives, including specialty drug management, biosimilar strategies, site-of-service opportunities, rebate and vendor strategies, and other roadmap priorities
• Maintain the pharmacy initiative roadmap and COHC program portfolio, ensuring initiatives are documented, prioritized, assigned to accountable owners, updated for status and milestones, and aligned to annual and multi-year financial targets

Your Knowledge and Experience

• Requires a Bachelor’s degree or High School Diploma/GED and 4 years of additional relevant experience in lieu of a degree. Master’s Degree is preferred
• Requires 10 years of prior relevant experience in pharmacy program development and implementation of companywide initiatives, organization development, and process improvement programs
• Previous program management experience in multi-disciplinary settings
• Knowledge of Blue Shield of California or similar health care organization structure
• Strong business acumen with proven experience in thinking strategically
• Strong data analytic and data management skills with the ability to perform analysis using summarized and/or detail claims information
• Strong collaboration and partnership skills in a matrixed work environment
• Excellent verbal and written skills with the ability to understand complex ideas and convey proposition statements to clinical and non-clinical audiences
• Experience in driving cross functional meetings to drive resolution of issues and/or establish priorities and timelines for program implementations
• Proficiency in Microsoft Word, Power Point, and Excel
• Detail oriented skills with the ability to work in a fast-paced environment
• Ability to successfully work with other functional departments within a health plan
• Ability to work independently with minimum direction or supervision
• Ability to produce accurate and quality work under tight deadlines
• Ability to manage challenging situations in a positive and constructive manner
• Ability to exhibit a “can do” attitude and solution-oriented approach to resolve challenges
• Ability to be a team player and be flexible in work assignments to provide support of peers
• TQM, Six Sigma certification or Project Management certification is preferred

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.