- Pay Range for California: $148940.00 to $223300.00
- Pay Range for Bay Area: $167896.00 to $251720.00
- Note: Please note that this range represents the pay range for this and many other positions at Blue Shield that fall into this pay grade. Blue Shield salaries are based on a variety of factors, including the candidate experience, location (California, Bay Area, or outside California), and current employee salaries for similar roles.
- Role can be filled by a candidate requiring sponsorship: No
Your Role
The Cost of Health Care (COHC) & Specialty Drug Management Pharmacy team is responsible for managing the Specialty Drug strategies across the pharmacy and medical benefit and leading and implementing cost of health care initiatives. The Pharmacist, Principal will report to the Director, Pharmacy COHC & Specialty Drug Management. In this role you will be responsible for oversight of the specialty pharmacy networks, limited distribution drug access, specialty-at-retail initiatives, direct drug distribution partnerships, and specialty pharmacy programs to improve affordability, access, quality, and member experience.
Our leadership model is about developing great leaders at all levels and creating opportunities for our people to grow – personally, professionally, and financially. We are looking for leaders that are energized by creative and critical thinking, building and sustaining high-performing teams, getting results the right way, and fostering continuous learning.
Responsibilities
Your Work
In this role, you will:
- Lead end-to-end specialty drug program strategy across pharmacy and medical benefit
- Manage specialty pharmacy, LDD, specialty-at-retail, and direct contracted distribution networks
- Monitor network performance, utilization, reimbursement, access, service levels, and financial outcomes
- Develop and oversee specialty pharmacy programs such as short fill, biosimilar, site-of-care, and affordability initiatives
- Partner with internal teams, vendors, manufacturers, and pharmacy networks to execute strategic initiatives
- Use analytics to evaluate specialty drug trends, measure program effectiveness, and present recommendations to leadership
Qualifications
Your Knowledge and Experience
- Requires a Doctor of Pharmacy (PharmD) degree from an accredited school of pharmacy in the U.S.
- Requires a current, active, and unrestricted California Registered Pharmacist (RPh) license
- Requires 4 years of experience in clinical pharmacy
- Experience in specialty pharmacy, managed care pharmacy, pharmacy benefit design, specialty networks, LDD programs, and biosimilar strategies
- Prior experience in evaluation of pharmacy program value and performance drivers
- Prior management experience in health plans or pharmacy benefit management companies, with deep knowledge of pharmacy benefit, formulary and network products, program strategies and competitive landscape
- Prior experience in vendor partnership, contract operations, negotiations, and performance management is preferred
- Possesses strong business acumen with proven experience in pharmacy strategy development and planning
- Strong knowledge of specialty drug reimbursement, contracting, distribution models, analytics, and vendor management
- Excellent communication skills with prior experience in presentations to internal and external executive level business stakeholders
- Demonstrated leadership, strategic planning, financial analysis, and cross-functional collaboration skills
- Detail-oriented with the ability to work in a fast-paced environment
- Exhibit "can do" attitude and solution-oriented approach to resolve challenges
Hybrid
This role requires employees to be in-office based on our hybrid workplace model, balancing purposeful in-person collaboration with flexibility. For most teams, this means coming into the office two days each week.
Employees living more than 50 miles from an office location will work with their manager to determine in-office time based on business need.
