Senior Clinical Pharmacist, Trend Management Strategies and Programs

Premera Blue Cross; Spokane (WA); Remote; USD 119,000 - 202,000; Full time

Benefits offered by this job

Medical, vision, dental coverage

401K with employer match

Tuition assistance

Paid time off

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 supports pharmacy savings, member affordability, and cross-functional product development.

The ideal candidate will drive initiatives across pharmacy and medical benefits, collaborate with Rx Product Managers, and guide clinical projects with a focus on strategic deployment and measurable outcomes.

Qualifications

• Pharmacist with an advanced degree or 6 years work experience (Required).
• Active US Pharmacist license in good standing (Required).
• Four years of clinical program development, management or consultation in a managed care setting (Required).

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, 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.
• Collaborate with Rx functional areas in designing and executing the high impact drug management strategies and tactics. Provide guidance to ensure cohesive execution of tactics.
• Conduct pilots with internal or external business partners, measure outcomes and lead other high-impact efforts such as external benchmarking activities.
• Develop position statements, outcomes reports, program presentations for internal or market facing needs.
• Maintain working knowledge of competitive intelligence, market surveillance of vendors and capabilities.
• Create trend and pipeline reports and insights to inform pharmacy strategies.

Skills

Communication skills

Presentation skills

Analytical skills

Team collaboration

Education

PharmD or MBA or MHA or MPH or 6 years experience

Tools

MS Word

Excel

PowerPoint

Outlook

Job description

Workforce Classification:

Telecommuter

Join Our Team: Do Meaningful Work and Improve People's Lives

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

Premera is committed to being a workplace where people feel empowered to grow, innovate, and lead with purpose. By investing in our employees and fostering a culture of collaboration and continuous development, we're able to better serve our customers. It's this commitment that has earned us recognition as one of the best companies to work for. Learn more about our recent awards and recognitions as a greatest workplace.

Learn how Premera supports our members, customers and the communities that we serve through our Healthsource blog: https://healthsource.premera.com/.

About the role of Sr. Clinical Pharmacist, Trend Management Strategies and Programs

Premera is seeking aSenior 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.

TheSr.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.

What you'll do:

• 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. Provide guidance to ensure cohesive execution of tactics.
• Conduct pilots with internal or external business partners, measure outcomes and lead other high-impact efforts such as external benchmarking activities.
• Develop position statements, outcomes reports, program presentations for internal or market facing needs.
• Maintain working knowledge of competitive intelligence, market surveillance of vendors and capabilities.
• Create trend and pipeline reports and insights to inform pharmacy strategies.

What you'll bring:

• Pharmacist with an advanced degree (e.g. PharmD, MBA, MHA, MPH) or six (6) years work experience. (Required)
• Active US Pharmacist license in good standing. (Required)
• Four (4) years of clinical program development, management or consultation in a managed care setting. (Required)
• 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. (Preferred)
• Demonstrated ability to lead and manage multiple, complex, concurrent projects.
• Ability to communicate effectively verbally and in writing; strong presentation skills.
• Proven ability to build and maintain relationships with both internal and external individuals.
• Ability to work independently, as well as a member of a team.
• Strong analytical skills; intermediate MS Word, Excel, PowerPoint and Outlook skills.
• Familiarity with local and regional health care issues.

Premera total rewards

Our comprehensive total rewards package provides support, resources, and opportunities to help employees thrive and grow. Our total rewards are more than a collection of perks, they're a reflection of our commitment to your health and well-being. We offer a broad array of rewards including physical, financial, emotional, and community benefits, including:

• Medical, vision, and dental coverage with low employee premiums.
• Voluntary benefit offerings, including pet insurance for paw parents.
• 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.
• Generous paid time off to reenergize.
• Looking for continuing education? We have tuition assistance for both undergraduate and graduate degrees.
• Employee recognition program to celebrate anniversaries, team accomplishments, and more.

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.

• Commuter perks make your trip to work less impactful on the environment and your wallet.
• Free convenient on-site parking.
• Subsidized on-campus cafes make lunchtime connections with colleagues fun and affordable.
• 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.
• Need a brain break? Challenge someone to a game of shuffleboard or ping pong while on campus.

Equal employment opportunity/affirmative action:

Premera is an equal opportunity/affirmative action employer. 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.

If you need an accommodation to apply online for positions at Premera, please contact Premera Human Resources via email at [e-mail] or via phone at 425-918-4785.

Premera is hiring in the following states, with some limitations based on role or city:

Alaska, Arizona, Arkansas, California, Colorado, Florida, Georgia, Idaho, Iowa, Kansas, Kentucky, Maine, Michigan, Minnesota, Missouri, Montana, Nevada, New Hampshire, New Mexico, North Carolina, Oklahoma, Oregon, South Carolina, South Dakota, Tennessee, Texas, Utah, Washington, Wisconsin.

The pay for this role will vary based on a range of factors including, but not limited to, a candidate's geographic location, market conditions, and specific skills and experience.

The salary range for this role is posted below; we generally target up to and around the midpoint of the range.

National Salary Range:

$118,900.00 - $202,100.00

National Plus Salary Range:

$135,600.00 - $230,500.00

*National Plus salary range is used in higher cost of labor markets including Western Washington and Alaska.

We're happy to discuss compensation further during the interview because we believe that open communication leads to better outcomes for all. We're committed to creating an environment where all employees are celebrated for their unique skills and contributions.