Government Specialty Pharmacy Director

🕒 Abril 23

🌾 Nebraska, Oregon, +1 estados a mais – Remoto

🌾 Nebraska – Remote 🌲 Oregon – Remote ⚔️ Virginia – Remote

💵 $141.980 - $204.225 / ano

⏰ Tempo Integral

🔴 Especialista

👔 Diretor

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Blue Cross Blue Shield Association

SiteLinkedInTodas as Vagas

1001 - 5000 funcionários

Fundada em 1960

⚕️ Seguro de Saúde

🤝 Sem Fins Lucrativos

Healthcare Insurance • Non-profit

A Blue Cross Blue Shield Association é uma associação de empresas independentes, operadas localmente, dedicadas a oferecer planos de seguro de saúde acessíveis e abrangentes. Oferece uma ampla gama de planos de saúde para indivíduos, famílias e empregadores, incluindo opções do Medicare. A Blue Cross Blue Shield Association está comprometida em promover a equidade em saúde e apoiar iniciativas de saúde mental, com o objetivo de tornar o atendimento à saúde fácil, acessível e disponível para todos. A associação é ativa em pesquisa de cuidados de saúde e advoga por um sistema de saúde mais equitativo.

Descrição

• Provide strategic leadership and oversight for the specialty pharmacy benefit serving a large federal member population • Lead the overall administration, operational delivery, regulatory compliance, and program performance • Serve as the enterprise owner of the specialty pharmacy benefit strategy for the Federal Employee Program • Build and maintain trusted partnerships with federal program leadership, senior internal stakeholders, and vendor partners • Lead executive program reviews and strategic discussions, presenting insights on program performance, emerging risks, and opportunities for improvement • Provide leadership across clinical, operational, financial, analytics, and PBM teams • Manage high-priority escalations and complex issues • Provide strategic oversight and governance of the specialty pharmacy benefit • Guide the planning, implementation, and continuous improvement of specialty pharmacy benefit programs • Monitor program performance through key operational, clinical, and service metrics • Ensure the specialty pharmacy program operates in full compliance with federal regulations, contractual obligations, and program governance standards • Provide strategic oversight of PBM and specialty pharmacy vendor relationships • Lead cross-functional teams responsible for implementing specialty pharmacy benefit updates, program enhancements, and regulatory changes • Leverage specialty pharmacy claims data, utilization trends, and operational metrics to evaluate program performance

🎯 Requisitos

• Bachelor's Degree in Pharmacy, Health Care Administration, Business or related field; or equivalent experience • Master's Degree (MBA or PharmD preferred) • 15+ Years Experience in account management, pharmacy benefit administration, PBM operations, specialty pharmacy, or federal health care program oversight • Strong understanding of specialty benefit design, utilization management, clinical programs, and PBM operations • Experience supporting, managing, or administering Federal programs (e.g., Federal Employee Program, TRICARE, VA, DoD, or other federally regulated healthcare benefits) • Direct experience with the Federal Employee Program (FEP), OPM requirements, or similar federal benefit environments preferred • Familiarity with specialty pharmacy workflows, prior authorization programs, and limited-distribution networks preferred • Knowledge of federal regulatory requirements, audit standards, and healthcare program compliance preferred • Demonstrated ability to manage large, complex accounts with multiple stakeholders • Excellent communication, presentation, and executive-facing engagement skills • Ability to interpret and translate pharmacy data into actionable insights • Experience leading cross-functional projects or program implementations.

🏖️ Benefícios

• Paid time off • 11 holidays • Medical/dental/vision insurance • Generous 401(k) matching • Lifestyle spending account • Annual bonus incentive pay