Senior Clinical Pharmacist – Trend Management Strategies, Programs

🔥 15 hours ago

🐻 Alaska, Arizona, +25 more states – Remote

🐻 Alaska – Remote 🌵 Arizona – Remote 🏄 California – Remote ⛰️ Colorado – Remote 🐊 Florida – Remote 🥔 Idaho – Remote 🌾 Iowa – Remote 🌪️ Kansas – Remote 🐎 Kentucky – Remote 🦞 Maine – Remote 🦬 Montana – Remote 🎰 Nevada – Remote 🗻 New Hampshire – Remote 🌶️ New Mexico – Remote 🌲 North Carolina – Remote 🌪️ Oklahoma – Remote 🌲 Oregon – Remote 🚗 Michigan – Remote ❄️ Minnesota – Remote 🏰 Missouri – Remote 🌴 South Carolina – Remote 🗿 South Dakota – Remote 🎸 Tennessee – Remote 🤠 Texas – Remote ⛷️ Utah – Remote ☕ Washington – Remote 🧀 Wisconsin – Remote

💵 $118.9k - $230.5k / year

⏰ Full Time

🟠 Senior

💊 Pharmacist

🦅 H1B Visa Sponsor

This company has sponsored H1B visas in the past.

👻 Ghost score 0%

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Premera Blue Cross

WebsiteLinkedInAll Job Openings

1001 - 5000 employees

Founded 1945

🏥 Healthcare

🛡️ Insurance

⚕️ Healthcare Insurance

Healthcare • Insurance • Healthcare Insurance

Premera Blue Cross is an independent health insurance provider, serving businesses and residents of Washington State and Alaska as a licensee of the Blue Cross Blue Shield Association. The company offers a range of health plans including individual, family, employer-based, and Medicare Supplement plans. However, it has announced that it will exit the Medicare Advantage market as of January 1, 2025. Premera is committed to advancing health equity and community support, evident through its Social Impact Program focused on behavioral health and homelessness solutions in Washington and Alaska. Additionally, Premera complies with federal and state civil rights laws, offering language assistance services to ensure equitable care.

📋 Description

• Develop clinical programs and products to manage cost and utilization trends of high-impact medications • Monitor utilization and cost trends of high-impact medications under pharmacy and medical benefits • Investigate and prepare trend management options • Develop, implement, and measure affordability improvement programs • Collaborate with cross-functional teams on formulary, utilization management, vendors, provider/member outreach, care management, and contracted networks • Manage relationships with service vendors supporting high-impact drug management • Provide clinical project and program guidance and monitor program performance • Partner with Rx Product Managers on pricing, reporting, product feasibility, marketing, sales training, and program maintenance • Collaborate with Rx functional areas to design and execute drug management strategies and tactics • Conduct pilots with internal or external business partners and measure outcomes • Lead external benchmarking activities and other high-impact efforts • Develop position statements, outcomes reports, and program presentations • Maintain competitive intelligence and market surveillance of vendors and capabilities • Create trend and pipeline reports and insights to inform pharmacy strategies

🎯 Requirements

• Pharmacist with an advanced degree (e.g. PharmD, MBA, MHA, MPH) or six (6) years work experience (Required) • Active US Pharmacist license in good standing (Required) • Four (4) years of clinical program development, management or consultation in a managed care setting (Required) • Experience in managed care pharmacy (Preferred) • Experience with project management (Preferred) • Experience with Medicare (Preferred) • Experience with Health Benefit Exchanges (Preferred) • Board Certified Pharmacotherapy Specialist (BCPS) (Preferred) • Health Plan claims analytics experience (Preferred) • Demonstrated ability to lead and manage multiple, complex, concurrent projects • Ability to communicate effectively verbally and in writing; strong presentation skills • Proven ability to build and maintain relationships with internal and external individuals • Ability to work independently and as a member of a team • Strong analytical skills • Intermediate MS Word, Excel, PowerPoint, and Outlook skills • Familiarity with local and regional health care issues

🏖️ Benefits

• Medical, vision, and dental coverage with low employee premiums • Voluntary benefit offerings, including pet insurance • Life and disability insurance • Retirement programs, including a 401K employer match and a pension plan vested after 3 years of service • Wellness incentives, including mental well-being resources, counseling services, stress management programs, and mindfulness programs • Generous paid time off • Tuition assistance for undergraduate and graduate degrees • Employee recognition program • On-campus flexibility for hybrid employees, with access to on-site resources, networking opportunities, and team engagement • Commuter perks • Free convenient on-site parking • Subsidized on-campus cafes • On-site health and wellness activities • Fitness and well-being center with in-person and virtual workouts and nutritional counseling • On-campus recreation, including shuffleboard and ping pong