Senior Manager, Pharmacy

🔥 0 minutes ago

🏈 Alabama, Arizona, +23 more states – Remote

🏈 Alabama – Remote 🌵 Arizona – Remote ⛰️ Colorado – Remote 🐊 Florida – Remote 🥔 Idaho – Remote 🌾 Iowa – Remote 🌪️ Kansas – Remote 🐎 Kentucky – Remote ⚜️ Louisiana – Remote 🌲 North Carolina – Remote 🏈 Ohio – Remote 🌪️ Oklahoma – Remote 🦀 Maryland – Remote 🚗 Michigan – Remote 🎸 Mississippi – Remote 🏰 Missouri – Remote 🔔 Pennsylvania – Remote 🌴 South Carolina – Remote 🗿 South Dakota – Remote 🎸 Tennessee – Remote 🤠 Texas – Remote ⛷️ Utah – Remote ⚔️ Virginia – Remote 🧀 Wisconsin – Remote 🦬 Wyoming – Remote

💵 $143.6k - $229.8k / year

⏰ Full Time

🟠 Senior

💊 Pharmacist

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Blue Cross NC

WebsiteLinkedInAll Job Openings

5001 - 10000 employees

Founded 1933

🏥 Healthcare

🛡️ Insurance

⚕️ Healthcare Insurance

Healthcare • Insurance • Healthcare Insurance

Blue Cross NC is a health insurance provider that offers a range of health plans and services to individuals and groups. The company focuses on delivering quality healthcare coverage and improving health outcomes for its members through innovative health programs and services. Blue Cross NC is committed to enhancing access to affordable healthcare while supporting the health and wellness of the communities it serves.

📋 Description

• Oversee utilization management operations and clinical review teams for an assigned Commercial or Government line of business • Develop and execute plans to achieve operational and quality targets • Maintain relationships with stakeholders, internal and external partners, and vendors • Promote collaboration across teams to leverage efficiencies, identify best practices, and drive implementation • Represent team needs in budget planning and divisional and enterprise roadmaps, including technology and digital initiatives • Serve as liaison between frontline staff, leadership, and cross-functional partners • Direct clinical and non-clinical operational aspects of pharmacy utilization management services • Support managers with prioritization, program monitoring, and corrective actions • Monitor dependencies, performance, and vendor/PBM services; identify risks, remove barriers, and escalate issues • Manage or support corporate and departmental projects affecting pharmacy utilization management operations and vendors • Manage utilization management programs and policies to achieve trend targets, reduce medical expense, and ensure cost-effective operations • Identify operational initiatives and process modifications to improve competitive position • Ensure programs comply with State, Federal, and accrediting-body regulations and implement corrective action plans • Evaluate pharmacy industry trends, best practices, challenges, and strategic needs to recommend and drive interventions and programs • Participate in departmental strategic plans and objectives to improve performance, revenue development, and member and provider experience • Provide clinical consultation on medication therapy and recommend utilization management strategies for traditional and specialty therapies • Represent the Pharmacy department on committees, C-suite presentations, speaking engagements, PBM meetings, and customer meetings

🎯 Requirements

• Bachelor's degree or advanced degree in Pharmacy • 8+ years of experience in a related field • In lieu of degree, 10+ years of experience in a related field • Current pharmacy license required • NC licensure may be needed for some roles • Experience leading people and supporting career/professional development preferred • Experience with culture and engagement support and interventions preferred • Resource and budget management experience preferred • Project planning and management experience preferred • Authorization to work in the United States

🏖️ Benefits

• Work-life balance, flexibility, and autonomy • Medical, dental, and vision coverage • Health and wellness programs • Parental leave and support • Adoption and surrogacy assistance • Career development programs • Tuition reimbursement for continued education • 401k match including an annual company contribution • Annual Incentive Bonus based on annual corporate goal achievement and individual performance • Paid Time Off (PTO) • Reasonable accommodations for applicants with disabilities