Senior Manager, Formulary & PBM Strategy

Blue Shield of California; California (MO); Ibrido; USD 149.000 - 223.000; Tempo pieno

Vantaggi offerti da questo lavoro

Hybrid work model

Two days in-office per week

Descrizione del lavoro

Blue Shield of California seeks a Senior Manager, Pharmacist of Formulary Management to lead formulary operations across CMS/Medicare and commercial lines. You will guide a team of pharmacists and operations specialists, coordinating with analytics, product, actuary, and vendors to drive affordability, quality and compliant submissions.

You will own formulary strategy development and implementation, oversight of UM rules, and ensure accuracy of SERFF filings while supporting accreditation and

Competenze

• PharmD degree from an accredited school of pharmacy in the US.
• Active and unrestricted CA RPh license.
• 8+ years of managed care pharmacy experience.
• 4+ years of people management experience.
• Experience with CMS/Medicare formulary and UM submissions.
• Strong data-driven decision making and analytical skills.

Mansioni

• Lead day-to-day formulary operations and team performance.
• Develop formulary strategies using clinical and claims data.
• Oversee installation of drug formularies and UM rules.
• Ensure CMS/Medicare and SERFF submissions are accurate.
• Coordinate cross-functional implementation with vendors and partners.
• Identify opportunities to improve quality, affordability, and efficiency.
• Support pharmacy residents and student precepting.

Formazione

Doctor of Pharmacy (PharmD)

California Registered Pharmacist (RPh) license

8 years managed care pharmacy experience

4 years people management experience

Analytical thinking and data-driven decisions

Advanced MS Office (Excel, Access, PowerPoint)

Strumenti

Microsoft Excel

Microsoft Access

PowerPoint

Descrizione del lavoro

Blue Shield of California seeks a Senior Manager, Pharmacist of Formulary Management to lead formulary operations across CMS/Medicare and commercial lines. You will guide a team of pharmacists and operations specialists, coordinating with analytics, product, actuary, and vendors to drive affordability, quality and compliant submissions.

You will own formulary strategy development and implementation, oversight of UM rules, and ensure accuracy of SERFF filings while supporting accreditation and