Government Specialty Pharmacy Director

🕒 vor 1 Monat

🌾 Nebraska, Oregon, +1 weitere Bundesländer – Remote

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

💵 $141.980 - $204.225 / Jahr

⏰ Vollzeit

🔴 Experte

👔 Direktor

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Blue Cross Blue Shield Association

WebsiteLinkedInAlle Stellen

1001 - 5000 Mitarbeiter

Gegründet 1960

⚕️ Krankenversicherung

🤝 Non-Profit

Healthcare Insurance • Non-profit

Die Blue Cross Blue Shield Association ist ein Verband unabhängiger, lokal betriebener Blue Cross und Blue Shield Gesellschaften, die sich der Bereitstellung erschwinglicher und umfassender Krankenversicherungspläne widmen. Sie bietet eine breite Palette von Gesundheitsplänen für Einzelpersonen, Familien und Arbeitgeber, einschließlich Medicare-Optionen. Die Blue Cross Blue Shield Association engagiert sich für die Förderung von Gesundheitsgerechtigkeit und unterstützt Initiativen im Bereich der psychischen Gesundheit, mit dem Ziel, Gesundheitsversorgung einfach, erschwinglich und für jeden zugänglich zu machen. Der Verband ist im Bereich der Gesundheitsforschung tätig und setzt sich für ein gerechteres Gesundheitssystem ein.

Beschreibung

• 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

🎯 Anforderungen

• 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.

🏖️ Vorteile

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