Director, Pharmacy - Drug Quality Program

Blue Shield of California; California; Híbrido; USD 180.000 - 260.000; Jornada completa

Descripción de la vacante

Blue Shield of California is seeking a Director, Pharmacist - Drug Quality Program to lead quality and affordability initiatives for prescription medications.

In this role, you will oversee strategy, collaborate with enterprise partners, and drive data-driven improvements while ensuring regulatory compliance and member outcomes. The position supports a hybrid work model with in-office days and strong leadership development opportunities.

Formación

• PharmD degree from an accredited U.S. school.
• Current active California Registered Pharmacist license.
• 10 years of relevant experience.
• 6 years of people management experience supervising staff.
• Knowledge of state quality rating systems and accreditation standards.
• Excellent written and verbal communication skills.
• Advanced clinical pharmacy practice in managed care or health plan pharmacy.
• Advanced data analytics using pharmacy claims data and KPIs.
• Proficiency in Microsoft applications.

Responsabilidades

• Collaborate with enterprise partners to improve drug quality and member experience measures, including Medicare Star Ratings and non-Medicare measures.
• Oversee factors impacting quality performance and health outcomes using data-driven methods; report to executives.
• Manage a multi-lever, multi-channel roadmap of programs aligned to the clinical strategy and regulatory requirements.
• Drive technology and vendor capabilities to boost operational efficiency and program performance.
• Engage with industry leaders to identify best practices and innovations.
• Lead according to BSC leadership behaviors and foster high-performing teams.
• Serve as a key stakeholder in Pharmacy operations, benefit & formulary design, and drug utilization management.

Conocimientos

Data analytics

Communication skills

Clinical pharmacy practice

Educación

PharmD degree

Herramientas

Microsoft Office

Descripción del empleo

Your Role

The Clinical Pharmacy Programs team within the Pharmacy Strategy & Operations department is a team of pharmacy professionals responsible for defining and executing strategies to address clinical quality and affordability of prescription medications used by Blue Shield of California (BSC) members. The Director, Pharmacist - Drug Quality Program, will report to the Senior Director, Clinical Pharmacy Programs. In this role, you will be responsible for performance on quality measures that address medication-related safety, health outcomes, and member experience related to accessing needed prescription drugs.

Job Description

Your Role

The Clinical Pharmacy Programs team within the Pharmacy Strategy & Operations department is a team of pharmacy professionals responsible for defining and executing strategies to address clinical quality and affordability of prescription medications used by Blue Shield of California (BSC) members. The Director, Pharmacist - Drug Quality Program, will report to the Senior Director, Clinical Pharmacy Programs. In this role, you will be responsible for performance on quality measures that address medication-related safety, health outcomes, and member experience related to accessing needed prescription drugs.

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

Your Work

In this role, you will:

• Collaborate with enterprise business partners to continuously improve upon the strategy to address drug related quality and member experience measures, including Part D measures in the Medicare Star Ratings system, and those that apply for non-Medicare members
• Oversee assessment of factors that impact quality performance and health outcomes using a results- and data-driven approach; monitor and report on program performance to enterprise stakeholders and executives
• Oversee a multi-lever, multi-channel roadmap and workplan of programs, initiatives, and tactics that are aligned to BSC’s clinical strategy, that meet enterprise quality and member experience goals, and that comply with regulatory and accreditation requirements
• Drive technology and vendor capabilities that improve operational efficiencies and enable program performance at the highest levels
• Network with industry leaders to identify best practices and innovations that improve outcomes for BSC members
• Lead according to BSC leadership behaviors and implement action plans that support employee engagement and high performing teams across the business unit and for your team
• Serve as a key leadership stakeholder in Pharmacy operations, benefit & formulary design, and drug utilization management

Qualifications

Your Knowledge and Experience

• Requires 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 10 years of prior relevant experience
• Requires 6 years of prior people management experience with direct responsibility for supervising, coaching, and evaluating direct reports
• Knowledge of national and California state quality rating systems; and applicable state, federal, and quality accreditation standards
• Excellent written and verbal communication skills
• Advanced clinical pharmacy practice and experience in managed care or health plan pharmacy business functions
• Advanced proficiency in data analytics, including use of pharmacy claims data, and designing key performance metrics
• Advanced proficiency in computer skills including but not limited to Microsoft 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 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 or disability status and any other classification protected by Federal, State and local laws.