Strategic Leader, Pharmacy Prior Authorization & Call Center

Blue Shield of CA; Phoenix (AZ); Hybrid; USD 240,000 - 340,000; Full time

Job summary

Blue Shield of California is seeking a Senior Director of Pharmacy Prior Authorization and Call Center to lead a 200+ team, shaping PA and call center operations for safe, cost-effective patient care.

In collaboration with the Medical Director, you will design and optimize processes cross-functionally, partner with vendors, and advance affordable access across lines of business. The role emphasizes leadership development and data-driven decision making.

Qualifications

• Requires PharmD degree from an accredited U.S. school of pharmacy.
• Requires an active and unrestricted California Registered Pharmacist (RPh) license.
• Requires 12 years of experience in managed care, PBM, or related settings; PA programs and call center ops.
• Requires 6 years of people management supervising direct reports.
• Vendor management experience preferred.
• Strong knowledge of therapeutic use of drugs and national guidelines preferred.

Responsibilities

• Design, implement, and optimize prior authorization processes.
• Lead and optimize call center operations to ensure clinically appropriate, cost-effective care.
• Partner with Medical Director and vendors to improve patient access and affordability.
• Develop and execute strategic operational plans to drive efficiency and cost outcomes.
• Manage a team of 200+ employees in a hybrid office setting.

Skills

People management

Vendor management

Financial acumen

Communication

Strategic thinking

Data-driven

Education

PharmD degree

California RPh license

Job description

Blue Shield of California is seeking a Senior Director of Pharmacy Prior Authorization and Call Center to lead a 200+ team, shaping PA and call center operations for safe, cost-effective patient care.

In collaboration with the Medical Director, you will design and optimize processes cross-functionally, partner with vendors, and advance affordable access across lines of business. The role emphasizes leadership development and data-driven decision making.