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Blue Shield of California

California nonprofit health insurance provider

Pharmacist Principal - LOB/Product

Product ManagementPosted on Nov 11
Full-time$148.9k - $251.7k /yrHybrid

About the Job

Requirements

  • A Doctor of Pharmacy (PharmD) degree is required.
  • A currently active and unrestricted California Registered Pharmacist (RPh) license is required.
  • Four years of experience in clinical pharmacy are required.
  • Strong presentation, verbal, and written skills are required, including the ability to understand and convey complex ideas to audiences with diverse backgrounds.
  • Strong business acumen with proven experience in strategy development and planning is required.
  • Proficiency in Microsoft Office products, particularly Microsoft Word, PowerPoint, and Excel, is required.

Responsibilities

  • Develop, analyze, and monitor prescription drug, medical claims, and program data to identify opportunities to improve healthcare quality and cost, and to monitor and report performance and outcomes.
  • Develop project proposals for identified opportunities and support their implementation.
  • Serve as a Blue Shield of California Pharmacy Services contact and subject matter expert to stakeholders, and manage external relationships with vendors and clients related to assigned work.
  • Serve as a primary pharmacy lead working with Medicare and/or Commercial business units to develop and implement pharmacy products and market initiatives aligned with business-unit growth and profitability objectives.
  • Lead or actively participate in cross-functional processes, including executive-audience forums, to brainstorm, influence, and recommend pharmacy strategies and initiatives supporting the value proposition, annual go-to-market planning, and multi-year roadmap planning.
  • Provide thought leadership and pharmacy marketplace intelligence to influence product and healthcare cost strategy development and prioritization.
  • Monitor pharmacy program performance, marketplace requirements, and mandate requirements; work cross-functionally and coordinate with business units such as Actuary and Product to support line-of-business management and develop solutions that differentiate Blue Shield of California.
  • Support issue resolution, communications, and solution development affecting pharmacy benefits and day-to-day operations to ensure line-of-business deliverables are met.
  • Support implementation of the Pharmacy Care Reimagined strategic initiative as appropriate.
  • Perform other duties as assigned.

Desired Qualifications

  • Experience working in a managed care or pharmacy benefit management setting is preferred.
  • Prior experience presenting pharmacy program recommendations, performance, value, and observations to executive leadership is preferred.
  • Prior experience in pharmacy benefit strategy and solutions development, with an understanding of pharmacy levers and marketplace requirements, is preferred.

About the Company

Blue Shield of California

California nonprofit health insurance provider

Blue Shield of California is a nonprofit health plan provider that offers medical insurance options for individuals, families, and employers within California. It operates as a mutual benefit corporation and maintains a broad network of healthcare professionals and facilities, enabling members to access care and manage claims through an online portal. Its services include preventive care programs and digital health coaching, with prior authorization required for certain medical, surgical, and some prescription drugs to control costs and ensure medical necessity. The company draws a substantial portion of its membership from CalPERS and focuses on delivering stable, affordable access to care within the state. Its goal is to provide members with reliable health coverage, a wide provider network, and tools to manage their health and expenses efficiently.

Company size
5,001-10,000
Company stage
Not listed
Total funding
Not listed
Headquarters
United States
Founded
1939

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