Director, Pharmacy Data and Analytics

Blue Shield of California; California; Hybrid; USD 180,000 - 280,000; Full time

Job summary

Blue Shield of California is seeking a Director, Pharmacist - Pharmacy Data & Analytics to lead the analytics strategy for a $5B+ spend portfolio. You will translate complex pharmacy data into insights, partnering with Strategy, Clinical, Finance, and external vendors to deliver dashboards and predictive models that improve affordability, outcomes, and member experience.

You will manage a multidisciplinary team, drive data governance, and present strategic insights to executives while fostering

Qualifications

• Requires a California Registered Pharmacist (RPh) license.
• Requires a Doctor of Pharmacy (PharmD) degree from a U.S. accredited school.
• Requires 10+ years in healthcare/pharmacy analytics, BI, or data science.
• Requires 6+ years of people management experience.

Responsibilities

• Oversee a team of Pharmacists, Data Analysts, and Program Managers.
• Develop and execute the data & analytics strategy for enterprise objectives.
• Lead dashboards, reporting, and predictive analytics for pharmacy spend sub-portfolio.
• Partner with leaders to measure performance and program impact.
• Drive cost-of-healthcare reporting, utilization analytics, and financial metrics.
• Ensure data quality, governance, and regulatory reporting.

Skills

Leadership

Communication

Strategic thinking

Problem solving

Presentation

Team management

Education

PharmD

California Pharmacist License

Tools

PowerBI

Tableau

Business Objects

SQL

Azure

Snowflake

Databricks

AWS

Google Cloud

Job description

Your Role

The Blue Shield of California (BSC) Pharmacy team comprises more than 350 dedicated professionals who are passionate about transforming pharmacy care and improving the health and well-being of the members we serve. Ensuring every member has safe, equitable access to high-quality and sustainably affordable pharmacy benefits is at the core of everything we do.

Job Description

As the Director, Pharmacist - Pharmacy Data & Analytics, you will lead the pharmacy organization's data, reporting, analytics, and business intelligence strategy to support informed decision-making across a pharmacy spend portfolio exceeding $5 billion annually. This role is responsible for translating complex pharmacy and healthcare data into actionable insights that drive affordability, clinical outcomes, operational performance, and member experience improvements across all lines of business. You will provide strategic leadership for enterprise pharmacy analytics, partnering closely with Pharmacy Strategy, Formulary, Clinical, Finance, Actuarial, Product, Operations, and external vendor partners to develop advanced analytical solutions, reporting, or data transfers that support key business priorities. This includes responsibility for developing performance measurement frameworks, leading trend and cost-of-healthcare analyses, evaluating data, and regulatory reporting.

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.

Responsibilities

• Oversee a team of Pharmacists, Business Analysts, Data Analysts, and Program Managers
• Develop and execute the pharmacy data and analytics strategy to support enterprise objectives, pharmacy affordability initiatives, clinical programs, and operational excellence
• Lead the design and delivery of executive dashboards, performance reporting, predictive analytics, forecasting models, and strategic insights
• Partner with business leaders to identify opportunities, measure performance, and evaluate the effectiveness of pharmacy programs and interventions
• Drive pharmacy trend analysis, cost-of-healthcare reporting, specialty drug analytics, utilization monitoring, and financial performance measurement
• Develop analytical frameworks to support formulary strategy, utilization management, specialty pharmacy management, provider-administered drug programs, and emerging pharmacy initiatives
• Collaborate with enterprise data, technology, and digital teams to enhance data infrastructure, reporting capabilities, and self-service analytics solutions
• Ensure data quality, integrity, governance, and compliance across pharmacy analytics and reporting functions
• Present findings, recommendations, and strategic insights to senior executives and cross-functional leadership teams
• Recruit, coach, mentor, and develop a high-performing analytics team while fostering a culture of innovation, continuous learning, and accountability

Qualifications

• Requires a currently active and unrestricted California Registered Pharmacist (RPh) license
• Requires a Doctor of Pharmacy (PharmD) degree from an accredited school of pharmacy in the U.S.
• Requires 10 years of prior relevant experience in healthcare, pharmacy, analytics, business intelligence, reporting, or data science
• Requires 6 years of prior people management experience with direct responsibility for supervising, coaching, and evaluating direct reports
• Experience working with large healthcare datasets, including pharmacy claims, medical claims, eligibility, provider, and financial data
• Experience with data visualization and business intelligence tools such as PowerBI, Tableau, Business Objects, or similar platforms
• Experience with SQL and healthcare data warehousing environments
• Experience with cloud-based data environments such as Azure, Snowflake, Databricks, AWS, or Google Cloud
• Understanding of healthcare quality measures, STAR ratings, HEDIS, and/or regulatory reporting
• Excellent presentation, verbal and written skills with ability to understand and convey complex ideas to audience with diverse backgrounds
• Detail-oriented with the ability to work in a fast-paced environment
• Exhibit a 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.

About Us

About Blue Shield of California

As of January 2025, Blue Shield of California became a subsidiary of Ascendiun. Ascendiun is a nonprofit corporate entity that is the parent to a family of organizations including Blue Shield of California and its subsidiary, Blue Shield of California Promise Health Plan; Altais, a clinical services company; and Stellarus, a company designed to scale healthcare solutions. Together, these organizations are referred to as the Ascendiun Family of Companies.

At Blue Shield of California, our mission is to create a healthcare system worthy of our family and friends and sustainably affordable. We are transforming health care in a way that genuinely serves our nonprofit mission by lowering costs, improving quality, and enhancing the member and physician experience.

To achieve our mission, we foster an environment where all employees can thrive and contribute fully to address the needs of the various communities we serve. We are committed to creating and maintaining a supportive workplace that upholds our values and advances our goals.

Blue Shield is a U.S. News Best Company to work for, a Deloitte U.S. Best Managed Company and a Top 100 Inspiring Workplace. We were recognized by Fair360 as a Top Regional Company, and one of the 50 most community-minded companies in the United States by Points of Light. Here at Blue Shield, we strive to make a positive change across our industry and communities – join us!

Our Values:

• 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 listen and communicate effectively, showing empathy by understanding others' perspectives.
• 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

We believe in fostering a workplace environment that balances purposeful in-person collaboration with flexibility - providing clear expectations while respecting the diverse needs of our workforce. Our workplace model is designed around intentional in-person interaction, collaboration, connection, creativity and flexibility:

• For most teams, this means coming into the office two days per week.
• Employees living more than 50 miles from an office location, out of state employees, and employees in certain member-facing roles should work with their manager to determine in‑office time based on business need.
• For employees with medical conditions that may impact their ability to work in‑office, we are committed to engaging in an interactive process and providing reasonable accommodations to ensure their work environment is conducive to their success and well‑being.

The Company reserves the right to require more presence in the office based on business needs, and requirements are subject to change with periodic reviews.

Physical Requirements:

Office Environment - roles involving part to full time schedule in Office Environment. 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.