Director, Pharmacy Solutions

The hiring range for this role is:  

125,870.00 - 176,525.00

This is the lowest to highest salary we, in good faith, believe we would pay for this role at the time of this posting.  We may ultimately pay more or less than the hiring range and this hiring range may also be modified in the future. A candidate’s position within the hiring range may be based on several factors including, but not limited to, specific competencies, relevant education, qualifications, certifications, relevant experience, skills, seniority, performance, shift, travel requirements, and business or organizational needs. This job is also eligible for annual bonus incentive pay. 

We offer a comprehensive package of benefits including paid time off, 11 holidays, medical/dental/vision insurance, generous 401(k) matching, lifestyle spending account and many other benefits to eligible employees. 

Note: No amount of pay is considered to be wages or compensation until such amount is earned, vested, and determinable. The amount and availability of any bonus, commission, or any other form of compensation that are allocable to a particular employee remains in the Company's sole discretion unless and until paid and may be modified at the Company’s sole discretion, consistent with the law. 

 

Job Description Summary:

Responsible for the development and implementation of clinical, operational, and business solutions, guidance, and products concerning pharmacy management on behalf of Blue Cross Blue Shield Association (BCBSA) and Blue Cross Blue Shield (BCBS) Plans. Engages and supports key pharmacy related BCBSA initiatives or affiliates, focusing on improving access, affordability, and member experience pertaining to drugs, digital therapeutics, high-cost outpatient generic drugs, and advanced therapies. Collaborates and coordinates with all functions related to medical and pharmacy management resources, clinical pipeline tracking, care management resources, network strategies, policy and evidentiary assessment development, and value-based payment models. Leads strategic cross functional projects and teams developing project scope and associated deliverables of significant complexity and/or impact to support Plans in their efforts to deliver quality, value, and accessibility for members.

Responsibilities include but are not limited to:

• Lead in the development of high-quality tools and resources addressing critical clinical, operational, market, and regulatory priorities.

• Serve as a key expert among BCBSA stakeholders, acting as a direct liaison to support the successful implementation and uptake of solutions provided by BCBS-owned entities.

• Contribute to the strategic direction of BCBSA governance through key clinical leadership groups.

• Engage with BCBS Plans and external stakeholders to support the development and consideration of innovative models related to clinical and business implementation.

• Develop pharmacy white papers and resources, including market scans, pipeline dashboards, insights, and leading practice recommendations for small molecule pharmacy therapeutics, specialty medical pharmacy, and advanced therapies.

Required Education, Certifications and Experience:

Education:

• Required: Doctorate - PharmD
• Preferred: Masters Degree - MBA

Experience:

Required:

• Minimum ten years related business experience

• Experience in health care industry and demonstrated progressive responsibility and accountability.

• Experience creating new business models for national implementation across multiple market and customer segments.

• Experience engaging with national peers that are skilled in healthcare innovation, evaluation and improvement of healthcare, and quality measures.

Preferred:

• Clinical pharmacy experience in managed care, and experience in advanced