Senior Clinical Pharmacist, Trend Management Strategies and Programs

Premera Blue Cross; Central City (CO); Hybrid; USD 140,000 - 180,000; Full time

Benefits offered by this job

Medical, Vision, Dental

401K with employer match

Pension plan vested after 3 years

Tuition assistance

On-site parking

Wellness resources and programs

On-site fitness and wellness center

Hybrid work arrangement

Job summary

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

You will collaborate across Rx Product, pricing, reporting, and care management to design and measure programs that optimize cost and outcomes. Hybrid on-site model with strong growth opportunities.

Qualifications

• Pharmacist with an advanced degree or six years of experience.
• Four years of clinical program development in managed care.
• Experience in managed care pharmacy and project management.
• Health Plan claims analytics experience.
• Ability to lead multiple complex projects and communicate effectively.

Responsibilities

• Lead trend management, affordability strategy, and clinical programs.
• Develop and communicate pharmacy initiatives to stakeholders.
• Monitor utilization and cost trends for high-impact medications.
• Collaborate with cross-functional teams on program design and deployment.
• Manage vendor relationships and program performance.
• Partner with Rx Product management on pricing, reporting, and maintenance.
• Create trend and pipeline reports to inform pharmacy strategies.

Skills

Pharmacist degree

Program development

Managed care pharmacy

Project management

Claims analytics

Stakeholder leadership

Verbal & written communication

MS Office proficiency

Education

PharmD or MBA/MHA/MPH

Tools

MS Word

MS Excel

MS PowerPoint

Outlook

Job description

Our purpose, to improve customers’ lives by making healthcare work better, is far from ordinary. Working at Premera means you have the opportunity to drive real change by transforming healthcare.

By investing in our employees and fostering a culture of collaboration and continuous development, we’re able to better serve our customers. Learn how Premera supports our members, customers and the communities that we serve through our Healthsource blog: .

Clinical Pharmacist, Trend Management Strategies and Programs

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

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. The ideal candidate has the ability to work effectively across the company with multiple stakeholders and can perform all the responsibilities of the clinical pharmacist with a greater emphasis on broader leadership, management and strategic deployment.
• 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.

Qualifications and Requirements

• 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.

we generally target up to and around the midpoint of the range.

Benefits

• Medical, vision, and dental coverage with low employee premiums.
• Life and disability insurance.
• Retirement programs, including a 401K employer match and, believe it or not, a pension plan that is vested after 3 years of service.
• Wellness incentives with a wide range of mental well-being resources for you and your dependents, including counseling services, stress management programs, and mindfulness programs, just to name a few.
• We have tuition assistance for both undergraduate and graduate degrees.
• For our hybrid employees, our on-campus model provides flexibility to create your own routine with access to on-site resources, networking opportunities, and team engagement.
• Free convenient on-site parking.
• Participate in engaging on-site activities such as health and wellness events, coffee connects, disaster preparedness fairs and more.
• Our complementary fitness & well-being center offers both in-person and virtual workouts and nutritional counseling.
• Challenge someone to a game of shuffleboard or ping pong while on campus.

Premera seeks to attract and retain the most qualified individuals without regard to race, color, religion, sex, national origin, age, disability, marital status, veteran status, gender or gender identity, sexual orientation, genetic information or any other protected characteristic under applicable law.