Director, Pharmacy - Drug Quality Program

Your Role

The Clinical Pharmacy Programs team within the Pharmacy Strategy & Operations department is a team of pharmacy professionals responsible for defining and executing strategies to address clinical quality and affordability of prescription medications used by Blue Shield of California (BSC) members. The Director, Pharmacist - Drug Quality Program, will report to the Senior Director, Clinical Pharmacy Programs. In this role, you will be responsible for performance on quality measures that address medication-related safety, health outcomes, and member experience related to accessing needed prescription drugs.

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.

Your Work In this role, you will:

Collaborate with enterprise business partners to continuously improve upon the strategy to address drug related quality and member experience measures, including Part D measures in the Medicare Star Ratings system, and those that apply for non-Medicare members

Oversee assessment of factors that impact quality performance and health outcomes using a results- and data-driven approach; monitor and report on program performance to enterprise stakeholders and executives

Oversee a multi-lever, multi-channel roadmap and workplan of programs, initiatives, and tactics that are aligned to BSC’s clinical strategy, that meet enterprise quality and member experience goals, and that comply with regulatory and accreditation requirements

Drive technology and vendor capabilities that improve operational efficiencies and enable program performance at the highest levels

Network with industry leaders to identify best practices and innovations that improve outcomes for BSC members

Lead according to BSC leadership behaviors and implement action plans that support employee engagement and high performing teams across the business unit and for your team

Serve as a key leadership stakeholder in Pharmacy operations, benefit & formulary design, and drug utilization management

Your Knowledge and Experience

Requires 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 10 years of prior relevant experience

Requires 6 years of prior people management experience with direct responsibility for supervising, coaching, and evaluating direct reports

Knowledge of national and California state quality rating systems; and applicable state, federal, and quality accreditation standards

Excellent written and verbal communication skills

Advanced clinical pharmacy practice and experience in managed care or health plan pharmacy business functions

Advanced proficiency in data analytics, including use of pharmacy claims data, and designing key performance metrics

Advanced proficiency in computer skills including but not limited to Microsoft applications

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.