Director, Pharmacy Strategy and Performance

Blue Shield of CA; Redding (CA); Hybrid; USD 180,000 - 260,000; Full time

Job summary

Blue Shield of California seeks a Director, Pharmacist - Strategy and Performance to lead enterprise pharmacy strategy across pharmacy and medical benefits. You will manage drug and network contracting, contract performance, and financial outcomes across multiple networks while partnering with executive leaders to maximize value for members and clients.

The role emphasizes leadership development, executive communication, and a culture of continuous learning within a hybrid in-office model in

Qualifications

• Requires active California RPh license.
• PharmD from an accredited U.S. school.
• 10+ years of experience in managed care health plan, pharmacy benefit management, or equivalent.
• 6+ years of people management experience supervising and coaching staff.
• Excellent communication and executive-level presentation experience.
• Knowledge of PBM, formulary, network programs for pharmacy and medical benefits.
• Vendor partnerships, contract operations, negotiations, and performance management preferred.

Responsibilities

• Lead a team to develop and execute enterprise pharmacy strategy across pharmacy and medical benefits.
• Oversee drug and network contracting, contract performance, and financial performance across provider-administered drugs, home infusion, and retail and specialty networks.
• Collaborate with Pharmacy Clinical Leadership, Medical Management, Finance, Actuary, and PBM partners to improve drug trend management and member value.
• Develop and communicate strategy; build and sustain high-performing teams; drive results with integrity and continuous learning.

Education

Doctor of Pharmacy (PharmD)

California Registered Pharmacist (RPh) license

Job description

Your Role

The Blue Shield of California (BSC) Pharmacy team comprises of over 350 dedicated professionals who are passionate about making a meaningful impact by reimagining pharmacy care. Ensuring every member has safe, equitable access to sustainably affordable pharmacy benefits is at the heart of everything we do.

The Director, Pharmacist - Strategy and Performance will report to the Vice President, Pharmacy Performance at BSC. In this role, you will lead a team responsible for developing and executing enterprise pharmacy strategy across the pharmacy and medical benefits. You will oversee drug and network contracting, contract performance, and financial performance across provider-administered drugs, home infusion, and retail and specialty pharmacy networks. Additionally, you will partner closely with Pharmacy Clinical Leadership, Medical Management, Finance, Actuary, Provider Contracting, and external pharmacy benefit management (PBM) partners to identify and implement strategies that improve drug trend management and maximize value for members, clients, and the organization.

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 Knowledge and Experience

• 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 a managed care health plan or pharmacy benefit management company or other relevant settings
• Requires 6 years of prior people management experience with direct responsibility for supervising, coaching, and evaluating direct reports
• Requires excellent communication skills with prior experience in presentations to internal and external executive level business stakeholders
• Knowledge of pharmacy benefits, formulary, network programs for drugs covered in pharmacy and medical benefits
• Prior experience in vendor partnership, contract operations, negotiations, and performance management is preferred
• Strong business acumen with proven experience in pharmacy strategy development and planning
• 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.