The Pharmacy Markets Analytics Product Strategy team leads a cross functional team in the development and implementation of pharmacy services and program strategy and innovation to support profitable membership growth and an affordable drug benefit. The Principal Pharmacist, Cost of Health Care will report to the Senior Manager, Pharmacy Services. In this role you will lead end to end drug strategy development with focus on drugs under the medical and outpatient prescription drug benefit. Potential strategies may include network, clinical, benefit and provider and member directed strategies to attain affordable pharmacy benefits for all lines of business.
In this role, you will:
- Lead review of medication costs, utilization and finance data to identify opportunities to optimize overall drug performance
- Work cross functionally with internal partners to validate opportunities and support the pharmacy cost management roadmap
- Identify and leverage drug trends, competitive intelligence, clinical information, and partnerships to establish and execute end to end drug strategies
- Establish, analyze and interpret pharmacy drug claims data to identify unit cost trends and opportunities
- Collaborate with initiative owners and analytics to establish savings calculations for submission to finance and actuary
- Lead strategic initiatives and innovation planning.
- Support inquiries from line of business owners and finance regarding drug utilization trends
- Identify and leverage drug trends, competitive intelligence, clinical information, and partnerships to establish and execute specialty drug strategies
Your Knowledge and Experience
- Requires a Doctor of Pharmacy (PharmD) degree
- Requires a currently active and unrestricted California Registered Pharmacist (RPh) license
- Requires at least 4 years of experience in clinical pharmacy
- Prior experience in pharmacy benefit management operations and demonstrated ability to interpret pharmacy benefit utilization and financial data is required.
- Must be proficient in MS Office, particularly MS Word, Power Point, and Excel
- Possesses strong business acumen with proven experience in thinking strategically required
- Strong data analytic and data management skills with the ability to perform analysis using summarized and/or detail claim information
Possesses excellent presentation, verbal, and written skills with ability to understand and convey complex ideas to audience with diverse backgrounds required
The pay range for this role is: $ 145200.00 to $ 217800.00 for California.
Please note that this range represents the pay range for this and many other positions at Blue Shield that fall into this pay grade. Blue Shield salaries are based on a variety of factors, including the candidate's experience, location (California, Bay area, or outside California), and current employee salaries for similar roles.
At Blue Shield of California we are parents, leader, students, visionaries, heroes, and providers. Everyday we come together striving to fulfill our mission, to ensure all Californians have access to high-quality health care at a sustainably affordable price. For more than 80 years, Blue Shield of California has been dedicated to transforming health care by making it more accessible, cost-effective, and customer-centric. We are a not-for-profit, independent member of the Blue Cross Blue Shield Association with 6,800 employees, more than $20 billion in annual revenue and 4.3 million members. The company has contributed more than $500 million to Blue Shield of California Foundation since 2002 to have a positive impact on California communities. Blue Shield of California is headquartered in Oakland, California with 18 additional locations including Sacramento, Los Angeles, and San Diego. We're excited to share Blue Shield of California has received awards and recognition for LGBT diversity, quality improvement, most influential women in corporate America, Bay Area's top companies in volunteering & giving, and one of the world's most ethical companies. Here at Blue Shield of California, we're striving to make a positive change across our industry and the communities we live in , Join us!
ABOUT THE TEAM
Blue Shield of California’s mission is to ensure all Californians have access to high-quality health care at a sustainably affordable price. We are transforming health care in a way that truly serves our nonprofit mission by lowering costs, improving quality, and enhancing the member and physician experience.
To fulfill our mission, we must ensure a diverse, equitable, and inclusive environment where all employees can be their authentic selves and fully contribute to meet the needs of the multifaceted communities we serve. Our comprehensive approach to diversity, equity, and inclusion combines a focus on our people, processes, and systems with a deep commitment to promoting social justice and health equity through our products, business practices, and presence as a corporate citizen.
Blue Shield has received awards and recognition for being a certified Great Place to Work, best place to work for LGBTQ equality, leading disability employer, one of the best companies for women to advance, Bay Area’s top companies in volunteering & giving, and one of the world’s most ethical companies. Here at Blue Shield of California, we are striving to make a positive change across our industry and the communities we live in – join us!
- Honest . We hold ourselves to the highest ethical and integrity standards. We build trust by doing what we say we're going to do and by acknowledging and correcting where we fall short.
- Human . We strive to be our authentic selves, listening and communicating effectively, and showing empathy towards others by walking in their shoes.
- Courageous . We stand up for what we believe in and are committed to the hard work necessary to achieve our ambitious goals.
Our Workplace Model:
Blue Shield of California is dedicated to making work-life balance a reality. Whether you prefer to work in an office or from home, we understand flexibility is more important than ever. That’s why Blue Shield is a hybrid company, offering you the opportunity to decide where you can do your best and most meaningful work.
Two ways of working: Hybrid (our default) and office
- Hybrid – In a business unit approved office a few times per year to 3 days per week, on average
- Office – In a business unit approved office 4+ days a week, on average. If the role you’re applying for is deemed an “Essential Role,” the company has determined that the role can only be performed in a Blue Shield office or in the field and would require your to meet the office worker classification.
Office Environment - roles involving part to full time schedule in Office Environment. Due to the current public health emergency in California, Blue Shield employees are almost all working remotely. Based in our physical offices and work from home office/deskwork - Activity level: Sedentary, frequency most of work day.
Equal Employment Opportunity:
External hires must pass a background check/drug screen. Qualified applicants with arrest records and/or conviction records will be considered for employment in a manner consistent with Federal, State and local laws, including but not limited to the San Francisco Fair Chance Ordinance. All qualified applicants will receive consideration for employment without regards to race, color, religion, sex, national origin, sexual orientation, gender identity, protected veteran status or disability status and any other classification protected by Federal, State and local laws.