Senior Clinical Pharmacist – Trend & Affordability

Premera Blue Cross; Clayton (NM); On-site; USD 120,000 - 170,000; Full time

Benefits offered by this job

Medical coverage

Vision & dental

401K match

Pension plan

Tuition assistance

On-site parking

Wellness resources

Hybrid work

Team events

Job summary

Premera Blue Cross is seeking a Senior Clinical Pharmacist to lead trend management strategies and affordability programs for high-impact medications. This role guides clinical program development, pharmacy savings, and cross-functional product initiatives across health plans.

The successful candidate will manage cost and utilization trends, collaborate with Rx Product Manager(s) on pricing, reporting, and program maintenance, and communicate findings to stakeholders to drive value for members

Qualifications

• Pharmacist with an advanced degree (e.g. PharmD, MBA, MHA, MPH) or six (6) years work experience.
• Four (4) years of clinical program development, management or consultation in a managed care setting.
• Experience in managed care pharmacy.
• Experience with project management.
• Health Plan claims analytics experience.
• Demonstrated ability to lead and manage multiple, complex, concurrent projects.
• Ability to communicate effectively verbally and in writing; intermediate MS Word, Excel, PowerPoint and Outlook skills.
• Familiarity with local and regional health care issues.

Responsibilities

• Clinical Pharmacist researches, develops, implements, and communicates to internal and external stakeholders, and manages pharmacy initiatives, programs and services that ensure clinically appropriate and cost-effective use of medication aligns with, and supports Premera's clinical and financial goals.
• 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, may include collaboration with cross functional teams using all relevant levers as interventions e.g. formulary, UM, vendors, provider/member outreach, collaboration with care management, contracted network, etc.
• Manage relationships with service vendors supporting high impact drug management, providing clinical project and program guidance, and monitor program performance.
• Partner with business counterpart Rx Product Manager(s) in pricing, reporting, product feasibility, marketing, sales training, and program maintenance (dyad model: clinical/business).
• Collaborate with Rx functional areas in designing and executing the high impact drug management strategies and tactics. Maintain working knowledge of competitive intelligence, market surveillance of vendors and capabilities.
• Create trend and pipeline reports and insights to inform pharmacy strategies.

Skills

Program development

Project management

Communication

Cross-functional collaboration

Healthcare analytics

Education

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 strategies and affordability programs for high-impact medications. This role guides clinical program development, pharmacy savings, and cross-functional product initiatives across health plans.

The successful candidate will manage cost and utilization trends, collaborate with Rx Product Manager(s) on pricing, reporting, and program maintenance, and communicate findings to stakeholders to drive value for members