Health Plan Pharmacist

Blue Cross Blue Shield of Wyoming; Cheyenne (WY); On-site; USD 120,000 - 150,000; Full time

Benefits offered by this job

Health insurance

Merit raises

Performance bonuses

Job summary

Blue Cross Blue Shield Wyoming is seeking a Health Plan Pharmacist to join the Pharmacy Team. You will help manage prescription drug benefits, control costs, and ensure regulatory compliance while collaborating with Prime Therapeutics as the PBM partner.

In this role you will bridge strategic initiatives with day-to-day operations, oversee formulary management, and act as a Brand Ambassador in the Wyoming community.

Qualifications

• PGY1 managed care residency accredited by AMCP/ASHP.
• Experience with health insurance payor.
• Experience with PBM partners.

Responsibilities

• Collaborate in management of prescription drug benefits, cost control, and regulatory compliance.
• Bridge BCBSWY and Prime Therapeutics (PBM) for long-term strategies and day-to-day operations.
• Oversee Group benefits consultation, formulary management, drug cost evaluations, network management, and pharmacy operations.
• Serve as a Brand Ambassador within the local community and region.

Skills

Managed care residency

PBM experience

Payor experience

Regulatory compliance

Education

PharmD degree

Wyoming pharmacist license

Certificate to practice Wyoming

MBA

MHA

Driver's license

Job description

About Blue Cross Blue Shield Wyoming

Deep Roots. Solid Growth. Caring People. Rooted in Wyoming! We are Blue Cross Blue Shield Wyoming: a not-for-profit health insurer with offices throughout the state. Ever since a small group of caring, persistent Wyoming women helped us put down roots in 1945, everything we do is aimed at better health care for the people of Wyoming.

Our Vision: We envision a future where integrity, compassion, and trust define a local health insurance experience. Committed to doing the right thing for our members, employees, and community, we strive to protect and contribute to the health and care of all we serve.

Our Mission: provide our members with access to local health insurance solutions that prioritize health, care, and well-being for those who call Wyoming home. If our passion and purpose resonate with you, you may be who we are looking for.

Role Overview

The role we are looking to fill: As a Health Plan Pharmacist with the BCBSWY Pharmacy Team, you will play an essential role in ensuring best-in‑class service to our members, providers, and the local community.

Are you ready to showcase your knowledge and skills in a professional role with a company recognized as a leader within the health insurance industry? By stepping into the role of a Health Plan Pharmacist, you will be responsible for collaborating in the management of specific operational, clinical, or client‑facing activities to manage prescription drug benefits, control costs, and ensure regulatory compliance.

This role will be a bridge between BCBSWY and Prime Therapeutics (our PBM). You will deal with long term strategies, high-level company initiatives, and day‑to‑day operations – overseeing functions including (but not limited to) Group benefits consultation, formulary management, drug cost evaluations, network management, and pharmacy operations.

As a recognized BCBSWY employee, we count on you to positively serve in the role of "Brand Ambassador" within the local community and/or geographical region. To your friends and neighbors - you ARE Blue Cross Blue Shield Wyoming! To be successful in this role, you will need to possess an earnest desire to help others, a commitment to doing the right thing, and a drive that pushes you to the next level every day.

Key Responsibilities

• Collaborate in the management of specific operational, clinical, or client‑facing activities to manage prescription drug benefits, control costs, and ensure regulatory compliance.
• Act as a bridge between BCBSWY and Prime Therapeutics (PBM) for long term strategies, high‑level company initiatives, and day‑to‑day operations.
• Oversee functions including Group benefits consultation, formulary management, drug cost evaluations, network management, and pharmacy operations.
• Serve as a "Brand Ambassador" within the local community and/or geographical region.

Preferred Qualifications

• PGY1 managed care pharmacy residency accredited by AMCP, ASHP.
• Masters of Healthcare Administration.
• Masters of Business Administration.
• Work experience with health insurance payor.
• Work experience with a PBM.

Minimum Qualifications

• Earned PharmD degree from an accredited institution.
• A current, unrestricted pharmacist license.
• Certificate to practice pharmacy in Wyoming.
• A current valid driver’s license.

Benefits and Compensation

BCBSWY Employees Enjoy: Best‑In‑Class Health Insurance at minimal to no‑cost for BCBSWY employees! PLUS many other benefits along with highly competitive compensation! Our compensation program is reviewed for competitive market match on an annual basis and employees are eligible for annual merit increases. Monthly incentives that are based on individual and company performance are also available to eligible employees and members of our Sales Team can realize generous performance‑based commissions.

Benefits include medical, dental, vision, 401(k), life insurance, paid time off (PTO), 10 paid holidays in addition to PTO annually, plus 8 paid volunteer hours, various wellness programs, and a dress code of "Dress for Your Day!" which can mean jeans every day (depending on your role).

Location and Flexibility

Our positions are all based in Wyoming. Depending on the department and the position, eligible employees may be offered limited In‑Office/WFH flexibility (for those positions that are offered limited WFH, there will be a required number of In‑Office days per week/month depending on department). Executive level employees are required to reside full‑time in Wyoming.

Selection Process

1. Review of your completed application and any additional submitted materials (e.g., cover letter, certifications, etc.) for minimum qualifications and skills alignment.
2. Confirmation of Wyoming residency, intent to become a Wyoming resident, or reasonable commuter distance if Colorado resident.
3. Recruiter Phone Screen.
4. Possible Self‑Assessment and/or Questionnaire.
5. Initial interview with Hiring Manager.
6. Possible 2nd Interview with Hiring Manager and/or additional Team members.
7. Comprehensive Background Check.

Equal Opportunity

BCBSWY is an Equal Opportunity Employer. We do not discriminate based on race, color, religion, national origin, sex, age, disability, genetic information, or any other status protected by law or regulation. Qualified applicants are provided with an equal opportunity and selection decisions are based on job‑related factors.

We use E‑Verify to confirm employment eligibility; we do not sponsor applicants for work visas.

BCBSWY is committed to the full inclusion of all qualified individuals. As part of this commitment, we will ensure that persons with disabilities are provided reasonable accommodations for the application, selection, and hiring process. If reasonable accommodation is needed, please contact: [e-mail].

Equal Opportunity is the Law. EEO is the Law. Supplement IER Right to Work FMLA E‑Verify Pay Transparency.

Company Culture

Working at Blue Cross Blue Shield of Wyoming | Great Place To Work® Rooted in Wyoming, Blue Cross Blue Shield Wyoming (BCBSWY) is a not‑for‑profit health insurer with offices throughout the state. Are you interested in joining the largest, most experienced insurer in Wyoming? If you are committed to excellent service above all else, you could be a great fit for an opportunity with BCBSWY.