Senior Clinical Pharmacist: Remote Trend & Cost-Management

Premera Blue Cross; Santa Fe (NM); Remote; USD 119,000 - 202,000; Full time

Benefits offered by this job

Medical benefits

Tuition assistance

Paid time off

Wellness programs

Pet insurance

401K match

Job summary

Premera Blue Cross is seeking a Senior Clinical Pharmacist to lead trend management, affordability strategy, and clinical program development for high-impact medications. This role supports pharmacy savings and member affordability while guiding cross-functional product development.

The ideal candidate will have a PharmD or equivalent, active pharmacist license in the US, and 4 years of clinical program development in managed care.

Qualifications

• Pharmacist with an advanced degree (e.g. PharmD, MBA, MHA, MPH) or six (6) years work experience.
• Active US Pharmacist license in good standing.
• Four (4) years of clinical program development, management or consultation in a managed care setting.
• Experience in managed care pharmacy preferred.
• Experience with project management preferred.
• Experience with Medicare preferred.
• Experience with Health Benefit Exchanges preferred.
• Board Certified Pharmacotherapy Specialist (BCPS) preferred.
• Health Plan claims analytics experience.
• Demonstrated ability to lead and manage multiple, complex, concurrent projects.
• Strong communication and presentation skills.

Responsibilities

• Develop clinical programs and products to manage cost and utilization trends of high impact medications.
• Monitor utilization and cost trend of high impact medications under both pharmacy and medical benefits, investigate and prepare trend management options.
• Develop, implement and measure affordability improvement programs with cross functional teams.
• Manage relationships with service vendors supporting high impact drug management.
• Partner with Rx Product Manager(s) in pricing, reporting, marketing, and program maintenance.
• Collaborate with Rx functional areas in designing high impact drug management strategies.
• Conduct pilots with internal or external partners and measure outcomes.
• Develop position statements, outcomes reports, and program presentations.
• Maintain knowledge of competitive intelligence and market surveillance.
• Create trend and pipeline reports to inform pharmacy strategies.

Skills

Pharmacist license

Advanced degree

Clinical program

Managed care

Project management

Medicare

Health exchanges

BCPS

Health plan analytics

Leadership

Communication

MS Office

Education

Pharmacist degree (PharmD)

MBA

MHA

MPH

Tools

MS Word

Excel

PowerPoint

Outlook

Job description

Premera Blue Cross is seeking a Senior Clinical Pharmacist to lead trend management, affordability strategy, and clinical program development for high-impact medications. This role supports pharmacy savings and member affordability while guiding cross-functional product development.

The ideal candidate will have a PharmD or equivalent, active pharmacist license in the US, and 4 years of clinical program development in managed care.