Blue Cross Blue Shield of North Carolina

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Director, Pharmacy Strategy

at Blue Cross Blue Shield of North Carolina

Posted: 9/18/2019
Job Status: Full Time
Job Reference #: RQ0005587
Keywords: operations

Job Description

Additional Locations:

Job Description

Direct, manage and lead efforts that define and enable strategic and operational priorities for the Pharmacy group. Lead staff responsible for accomplishing goals related to pharmacy operations, clinical and specialty pharmacy programs, opportunity analysis, solution design, provider/payer integration and vendor evaluation and management. Provides expertise and insights for new services, operational improvements, and partnerships to drive pharmacy cost reductions and quality of care initiatives. Champion innovation while identifying pharmacy related opportunities and collaborations that drive value for Blue Cross NC members.

Direct, manage and lead efforts that define and enable strategic and operational priorities for the Pharmacy group. Lead staff responsible for accomplishing goals related to pharmacy operations, clinical and specialty pharmacy programs, opportunity analysis, solution design, provider/payer integration and vendor evaluation and management. Provides expertise and insights for new services, operational improvements, and partnerships to drive pharmacy cost reductions and quality of care initiatives.  Champion innovation while identifying pharmacy related opportunities and collaborations that drive value for Blue Cross NC members.

Leadership Responsibilities:

  • People leadership
  • Resource management
  • Project planning and management

Core Responsibilities:

Strategy

  • Evaluates emerging pharmacy industry trends and the strategic needs of the department as it relates to overall business objectives.
  • Translates strategy into defined tactics, programs/projects, priorities and timelines and ensures alignment with Healthcare objectives and enterprise goals.
  • Participates in the development of departmental strategic plans and objectives to improve quality of care and achieve medical expense goals.
  • Understands the evolving medication therapy space and develops strategies around traditional, specialty and gene therapies.

Operations

  • Directs the management of operational aspects of pharmacy services.
  • Oversees day-to-day operations of pharmacy benefits management and other related vendors to meet the needs of the membership and remain responsive to the company’s needs to achieve customer expectations and financial and performance targets.
  • Directs, manages, and/or supports implementation of corporate projects that impact operational aspects of pharmacy services and its vendors

Partnership and Vendor Management

  • Evaluate and manage new and/or existing vendors and solution partners to align to BCNC’s strategic direction
  • Develops economic or quality models to evaluate new vendors

Program management and quality/compliance

  • Directs the development and oversight of specialty pharmacy initiatives and pharmacy utilization management programs and policies to manage trend targets and reduce medical expense.
  • Provides oversight over Medicare Part D Star and pharmacy related HEDIS measures.
  • Manages and oversees the development of and monthly maintenance of cost-effective formularies
  • Identifies new clinical initiatives and modifications to current programs and processes to improve the company’s competitive position.
  • Ensures programs are compliant in accordance with regulations of State, Federal, and other accrediting bodies and ensures corrective action plans are implemented.

Communications

  • Represents the Pharmacy department at internal meetings by active participation in cross functional organizational committees ensuring corporate fitness and market position.
  • Represent BCNC through delivery of presentations, speaking engagements and participation at PBM meetings/committees or external customer meetings as needed.

Innovation

  • Drive leadership in project planning, designing and implementing innovative solutions around medication management
  • Evaluation of investment/partnership opportunities

Hiring Requirements

  • Bachelor’s degree and 10 years of experience in pharmacy benefits management, managed care, and/or strategic or product development.
  • OR PharmD/relevant Master’s degree (MBA/MHA) with 8 years of experience as stated above.
  • 5 years of leadership experience, leading people and/or complex, cross divisional projects or programs.
  • For some positions, a current pharmacy license is required.

Hiring Preferences

  • Pharmacist (PharmD, BSPharm) or MBA/MHA preferred.
  • Previous experience conducting financial analysis and business case development preferred.

It's an exciting time to work at Blue Cross and Blue Shield of North Carolina. Health care is changing, and we're leading the way. We offer more than health insurance our customers can count on. We’re committed to better health and better health care - in our communities and beyond. Our employees bring energy and creativity to the workplace, and it shows in our innovative approach to improving the health and well-being of North Carolinians.

Our company is a not-for-profit with headquarters in Durham and major operations in Winston-Salem and Fayetteville. In all we employ more than 4,900 North Carolinians and serve more than 3.9 million customers.

Help us lead the charge for better health care by joining our award-winning team. Discover tremendous opportunities with us to do challenging and rewarding work. Opportunities that can lead you to a fulfilling career, work that can help others lead healthier, happier lives.

Third Party Staffing Agencies

Blue Cross NC does not accept unsolicited resumes from any source other than directly from candidates. For the protection of all parties involved in the recruiting process, resumes will only be accepted from recruiters/agencies if a signed agreement is in place at the inception of the recruiting effort and authorized for a specific position. Unsolicited resumes sent to Blue Cross NC from recruiters/agencies do not constitute any type of relationship between the recruiter/agency and Blue Cross NC and do not obligate Blue Cross NC to pay fees if we hire from those resumes.



Posted 30+ Days Ago

Full time

RQ0005587