Program Manager, Consultant - Pharmacy Strategy & Operations

RiseMe; Oakland (CA); Hybrid; USD 130,000 - 170,000; Full time

Job summary

Blue Shield of California is seeking a Program Manager, Consultant to support pharmacy programs within the Pharmacy Strategy and Operations team. You will report to the Sr.

Manager, Pharmacy Programs and collaborate with Commercial and Government Markets to deliver consultant-level guidance on pharmacy initiatives. This role emphasizes leadership, cross-functional collaboration, and rigorous analysis to drive outcomes.

Qualifications

• Requires a Bachelor's degree or High School Diploma/GED with 4 years of additional relevant experience; Master’s degree preferred.
• Requires 7 years of prior relevant experience with Pharmacy or health program management and/or consulting.
• Deep understanding of program and resource management, strong business acumen, and team focus.
• Knowledge of Blue Shield of California, Commercial line of business, and/or IFP is preferred.

Responsibilities

• Provide overall program leadership, guidance, and manage all aspects of a given program, including requirements gathering and implementation.
• Develop resourcing strategies to ensure optimum support for projects and day-to-day operations.
• Review program budget variance and scope change requests; participate in budget-resolution process.
• Lead cross-functional meetings; drive escalation and coordination across stakeholders.

Skills

Program management

Budget management

Stakeholder management

Team leadership

Analytical skills

Education

Bachelor’s degree

High School Diploma/GED

Job description

Your Role

The Pharmacy Strategy and Operations team provides pharmacy benefit management services and strategies to support Blue Shield of California affordability and membership goals. The Program Manager, Consultant will report to the Sr. Manager, Pharmacy Programs. In this role you will support the Commercial and Government Markets lines of business and will provide consultant level support for pharmacy programs.

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

• Provide overall program leadership, guidance, and manage all aspects of a given program, including requirements gathering, business case creation, and implementation
• Develop resourcing strategies to ensure optimum support for projects and for the day-to-day operational activities
• Review program budget variance and scope change requests, and participate in the budget-resolution process
• Lead cross-functional meetings and foster teamwork; drive escalation and resolution of issues, while promoting collaboration and coordination across broad categories of stakeholders
• Support and coach project managers within the program, while providing technical expertise in planning, execution, and leadership of program, projects, and initiatives
• Lead operational initiatives across the government markets lines of business working directly with product cycle managers, sales, brokers and internal departments to ensure proper implementation and administration of initiatives and timely updates to member and program materials
• Partner with the Account and Sales Pharmacists to coordinate and complete competitive pharmacy request for proposal (RFP) responses for the government markets line of business
• Manage new client implementations by working with clients and service providers to identify onboarding & ongoing requirements and driving stakeholders towards timely delivery
• Manage the pharmacy member experience by proactively addressing member and client concerns, identifying resolutions or alternative solutions
• Develop and prepare line of business (LOB) reporting, program status, and other senior level or executive level presentations for 1/1 readiness and other strategic initiatives
• Support Pharmacy Care Reimagined strategic initiative implementation as appropriate

Qualifications

Your Knowledge and Experience

• Requires a Bachelor’s degree or High School Diploma/GED and 4 years of additional relevant experience in lieu of a degree. Master’s degree preferred
• Requires 7 years of prior relevant experience with Pharmacy or health program management and/or consulting
• Requires a deep understanding of program and resource management, strong business acumen, and team focus
• Knowledge of Blue Shield of California, Commercial line of business, and/or Individual and Family Plans (IFP) is preferred
• Ability to work in a fast-paced multidisciplinary environment
• Excellent analytical and problem-solving skills

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 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 isa 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.

OurWorkplace 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. Ourworkplace modelis designed around intentional in-person interaction, collaboration, connection,creativityand 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 torequiremore 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.