About this role
Your Role
The Cost of Health Care (COHC) & Specialty Drug Management Pharmacy team is responsible for managing the Specialty Drug strategies across the pharmacy and medical benefit and leading and implementing cost of health care initiatives. The Pharmacist, Principal will report to the Director, Pharmacy COHC & Specialty Drug Management. In this role you will be responsible for oversight of the specialty pharmacy networks, limited distribution drug access, specialty-at-retail initiatives, direct drug distribution partnerships, and specialty pharmacy programs to improve affordability, access, quality, and member experience.
Our leadership model is about developing great leaders at all levels and creating opportunities for our people to grow – personally, professionally, and financially. We are looking for leaders that are energized by creative and critical thinking, building and sustaining high-performing teams, getting results the right way, and fostering continuous learning.
RESPONSIBILITIES
Your Work In this role, you will:
* Lead end-to-end specialty drug program strategy across pharmacy and medical benefit * Manage specialty pharmacy, LDD, specialty-at-retail, and direct contracted distribution networks * Monitor network performance, utilization, reimbursement, access, service levels, and financial outcomes * Develop and oversee specialty pharmacy programs such as short fill, biosimilar, site-of-care, and affordability initiatives * Partner with internal teams, vendors, manufacturers, and pharmacy networks to execute strategic initiatives * Use analytics to evaluate specialty drug trends, measure program effectiveness, and present recommendations to leadership
QUALIFICATIONS
Your Knowledge and Experience
* Requires a Doctor of Pharmacy (PharmD) degree from an accredited school of pharmacy in the U.S. * Requires a current, active, and unrestricted California Registered Pharmacist (RPh) license * Requires 4 years of experience in clinical pharmacy * Experience in specialty pharmacy, managed care pharmacy, pharmacy benefit design, specialty networks, LDD programs, and biosimilar strategies * Prior experience in evaluation of pharmacy program value and performance drivers * Prior management experience in health plans or pharmacy benefit management companies, with deep knowledge of pharmacy benefit, formulary and network products, program strategies and competitive landscape * Prior experience in vendor partnership, contract operations, negotiations, and performance management is preferred * Possesses strong business acumen with proven experience in pharmacy strategy development and planning * Strong knowledge of specialty drug reimbursement, contracting, distribution models, analytics, and vendor management * Excellent communication skills with prior experience in presentations to internal and external executive level business stakeholders * Demonstrated leadership, strategic planning, financial analysis, and cross-functional collaboration skills * Detail-oriented with the ability to work in a fast-paced environment * Exhibit "can do" attitude and solution-oriented approach to resolve challenges
Hybrid
This role requires employees to be in-office based on our hybrid workplace model, balancing purposeful in-person collaboration with flexibility. For most teams, this means coming into the office two days each week.
Employees living more than 50 miles from an office location will work with their manager to determine in-office time based on business need.
About Blue Shield of California
As of January 2025, Blue Shield of California became a subsidiary of Ascendiun. Ascendiun is a nonprofit corporate entity that is the parent to a family of organizations including Blue Shield of California and its subsidiary, Blue Shield of California Promise Health Plan; Altais, a clinical services company; and Stellarus, a company designed to scale healthcare solutions. Together, these organizations are referred to as the Ascendiun Family of Companies.
At Blue Shield of California, our mission is to create a healthcare system worthy of our family and friends and sustainably affordable. We are transforming health care in a way that genuinely serves our nonprofit mission by lowering costs, improving quality, and enhancing the member and physician experience.
To achieve our mission, we foster an environment where all employees can thrive and contribute fully to address the needs of the various communities we serve. We are committed to creating and maintaining a supportive workplace that upholds our values and advances our goals.
Blue Shield is a U.S. News Best Company to work for, a Deloitte U.S. Best Managed Company and a Top 100 Inspiring Workplace. We were recognized by Fair360 as a Top Regional Company, and one of the 50 most community-minded companies in the United States by Points of Light. Here at Blue Shield, we strive to make a positive change across our industry and communities – join us!
Our Values:
* Honest. We hold ourselves to the highest ethical and integrity standards. We build trust by doing what we say we're going to do and by acknowledging and correcting where we fall short. * Human. We strive to listen and communicate effectively, showing empathy by understanding others' perspectives. * Courageous. We stand up for what we believe in and are committed to the hard work necessary to achieve our ambitious goals.
Our Workplace Model
We believe in fostering a workplace environment that balances purposeful in-person collaboration with flexibility - providing clear expectations while respecting the diverse needs of our workforce. Our workplace model is designed around intentional in-person interaction, collaboration, connection, creativity and flexibility:
* For most teams, this means coming into the office two days per week.
* Employees living more than 50 miles from an office location, out of state employees, and employees in certain member-facing roles should work with their manager to determine in-office time based on business need.
* For employees with medical conditions that may impact their ability to work in-office, we are committed to engaging in an interactive process and providing reasonable accommodations to ensure their work environment is conducive to their success and well-being.
The Company reserves the right to require more presence in the office based on business needs, and requirements are subject to change with periodic reviews.
Physical Requirements:
Office Environment - roles involving part to full time schedule in Office Environment. Based in our physical offices and work from home office/deskwork - Activity level: Sedentary, frequency most of work day.
Please click here for further physical requirement detail. [https://www.blueshieldca.com/physical-job-requirements]
Equal Employment Opportunity:
External hires must pass a background check/drug screen. Qualified applicants with arrest records and/or conviction records will be considered for employment in a manner consistent with Federal, State and local laws, including but not limited to the San Francisco Fair Chance Ordinance. All qualified applicants will receive consideration for employment without regards to race, color, religion, sex, national origin, sexual orientation, gender identity, protected veteran status or disability status and any other classification protected by Federal, State and local laws.