Job Description
Job Description Your Role The Pharmacist, Principal, Formulary and Pharmacy & Therapeutics (P&T) reports to the Senior Manager of Pharmacy & Therapeutics. The Pharmacist, Principal is responsible for development of drug and drug class reviews by researching clinical evidence and guidelines, analyzing data including comparative effectiveness and budget impact data to support clinically appropriate and cost-effective formulary management of drugs. In this role, you will collaborate with stakeholders to develop, coordinate, and evaluate pharmacoeconomic outcomes and value-based assessments to support formulary decision making. This role works with Clinical Pharmacists and others to support Blue Shield of California's mission and strategy.
Responsibilities Your Work In this role, you will:
- Facilitate formulary development and provide P&T clinical support based on scientific evidence and standards of practice, including assessing peer-reviewed literature, pharmacoeconomic studies, outcomes research data [e.g. comparative effectiveness research (CER)], and budget impact assessments
- Collaborate with the analytics team to develop pharmacoeconomic analyses and complete outcomes research and make recommendations to management and P&T to support cost effective formulary management
- Develop and analyze prescription drug and medical claims data reports to identify opportunities to improve quality and cost-effective use of drugs
- Regularly assess the medical evidence to ensure medications are utilized appropriately through the annual medication review process
- Collaborate with management and cross-functional teams to create a plan for maintaining development and implementation of a value-based formulary design, including P&T process changes to support value-based formulary decisions
- Prepare client-facing clinical summaries supporting documentation and reports
- Lead communication efforts about clinical value propositions across therapeutic areas
- Perform retrospective data analysis and healthcare cost analysis for formulary decision and formulary maintenance to manage cost of healthcare
- Conduct presentations at formulary meetings, P&T committees, and drug utilization review (DUR) meetings
- Work independently and collaboratively with multidisciplinary/cross-functional teams with minimal oversight and direction from the Manager
Qualifications Your Knowledge and Experience - Requires a Doctor of Pharmacy (PharmD) degree
- Requires a currently active and unrestricted California Registered Pharmacist (RPh) license
- Requires 4 years of experience in clinical pharmacy
- Experience working in a managed care setting and direct client and provider interface is preferred
- Demonstrated leadership skills/capabilities
- Thorough clinical knowledge regarding therapeutic use of drugs
- Excellent oral and written communication skills
- Excellent presentation skills
- Strong problem-solving, math, and analytical skills
- Strong project or program management skills
- Ability to work independently and as part of a team (including remotely)
- Proficiency with Microsoft Office applications
About the Team Blue Shield of California's mission is to ensure all Californians have access to high-quality health care at a sustainably affordable price. 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 fulfill our mission, we must ensure a diverse, equitable, and inclusive environment where all employees can be their authentic selves and fully contribute to meet the needs of the multifaceted communities we serve. Our continued commitment to diversity, equity, and inclusion upholds our values and advances our goal of creating a healthcare system that is worthy of our family and friends while addressing health disparities, promoting social justice, and integrating health equity through our products, business practices, and presence as a corporate citizen.
Blue Shield has received awards and recognition for being a certified Fortune 100 Best Companies to Work, Military Friendly Employer, People Companies that Care, a Leading Disability Employer, and one of California's top companies in volunteering and giving. 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 be our authentic selves, listening and communicating effectively, and showing empathy towards others by walking in their shoes.
- 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: At Blue Shield of California, we believe in fostering a workplace environment that balances purposeful in-person collaboration with flexibility. As we continue to evolve our workplace model, our focus remains on creating spaces where our people can connect with purpose - whether working in the office or through a hybrid approach - by providing clear expectations while respecting the diverse needs of our workforce.
Two Ways of Working:
- Hybrid (Default): Work from a business unit-approved office at least two (2) times per month (for roles below Director-level) or once per week (for Director-level roles and above).Exceptions:
- Member-facing and approved out-of-state roles remain remote.
- Employees living more than 50 miles from their assigned offices are expected to work with their managers on a plan for periodic office visits.
- 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.
- On-Site: Work from a business unit-approved office an average of four (4) or more days a week.
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.
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. Blue Shield of California
Job Tags
Full time, Part time, Local area, Remote job, Home office,