Senior Clinical Pharmacist, Trend Management Strategies and Programs

Premera Blue Cross; United States; Remote; USD 150,000 - 190,000; Full time

Benefits offered by this job

Medical, vision, and dental coverage

Pet insurance

401K employer 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 drives pharmacy savings, member affordability, and cross-functional product development while aligning with Premera's clinical and financial goals.

The ideal candidate has a PharmD or advanced degree or substantial managed care experience, with a US pharmacist license in good standing and strong leadership

Qualifications

• Active US Pharmacist license in good standing.
• 4 years of clinical program development, management or consultation in managed care.
• Experience in managed care pharmacy.
• Board Certification Pharmacotherapy Specialist (BCPS) is preferred.

Responsibilities

• Develop clinical programs and products to manage cost and utilization trends of high impact medications.
• Monitor utilization and cost trends under pharmacy and medical benefits.
• Develop affordability improvement programs with cross-functional teams.
• Manage relationships with service vendors for high impact drug management.
• Collaborate with Rx Product Manager in pricing, reporting and program maintenance.

Skills

Pharmacist licensure

Clinical program leadership

Cross-functional collaboration

Analytical skills

Education

Advanced pharmacy degree or 6 years in managed care

Tools

MS Word

MS Excel

MS PowerPoint

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: .

About the role of Sr. 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. The Sr . 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 no