JOB DESCRIPTION
Your Role

The Pharmacy Services Prior Authorization team conducts medical necessity reviews for drug coverage. The Pharmacist Manager will report to the Pharmacist Senior Manager, Pharmacy Benefit Prior Authorization. In this role, you will support the Blue Shield of California Pharmacy and Therapeutics (P&T) Committee process by ensuring that evidence-based clinical decisions are implemented operationally to support safe, efficacious, and cost-effective prescribing of medications. 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:

• Provide oversight for the management of program area operations and employees
• Be responsible for promotion and execution of overall vision, goals, objectives of the business unit
• Provide oversight for the coordination of activities of the program area with other business units and monitor operational statistics to ensure all respective accreditation, regulatory and compliance requirements are met
• Provide oversight for the development, implementation, coordination, and assessment of programs to improve quality and cost-effectiveness
• Demonstrate leadership principles daily and ensure team actions are in place to make Blue Shield a great place to work
• Regularly monitor program data and metrics to evaluate program effectiveness and outcomes; reports to appropriate committees, managers, and other internal or external stakeholders
• Support other teams within and outside of the Pharmacy Services department with subject matter expertise
• Precept Pharmacy Practice Residents and students, as assigned. Maintain required residency program documentation and meet standards for preceptorship

QUALIFICATIONS
Your Knowledge and Experience

• Requires a Doctor of Pharmacy (PharmD) degree
• Requires at least 5 years of experience in a managed care setting, including at least 3-5 years of management experience or equivalent
• Requires an active and unrestricted California Registered Pharmacist (RPh) license
• Demonstrates thorough knowledge regarding therapeutic use of drugs
• Understands basic management approaches such as work scheduling, prioritizing, coaching and process execution, work organization, risk management and delegation
• Experience in leading and managing the execution of processes, projects, and tactics
• Demonstrates critical thinking and effective decision-making
• Advanced skills analyzing data to make business decisions

Pay Range:

The pay range for this role is: $ 118800.00 to $ 178200.00 for California.

Note:

Please note that this range represents the pay range for this and many other positions at Blue Shield that fall into this pay grade. Blue Shield salaries are based on a variety of factors, including the candidate's experience, location (California, Bay area, or outside California), and current employee salaries for similar roles.

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 truly 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 comprehensive approach to diversity, equity, and inclusion combines a focus on our people, processes, and systems with a deep commitment to promoting social justice and health equity through our products, business practices, and presence as a corporate citizen.

Blue Shield has received awards and recognition for being a certified Great Place to Work, best place to work for LGBTQ equality, leading disability employer, one of the best companies for women to advance, Bay Area’s top companies in volunteering & giving, and one of the world’s most ethical companies. Here at Blue Shield of California, we are striving to make a positive change across our industry and the communities we live in – 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.

From the earliest days of the pandemic, Blue Shield of California has been unyielding in our commitment to putting the health and safety of our people, our members and our communities first. As a health care company, Blue Shield requires all employees to be up to date with COVID-19 vaccination prior to start date as a condition of employment. Blue Shield will consider requests for medical or religious accommodation to this vaccination requirement prior to your start date.

The definition of "up to date with your COVID-19 vaccine" is when you have received all doses in the primary series and one booster when eligible. If you are unable to be up to date with your COVID-19 vaccine by your start date, your start date will need to be postponed and you will have 30 days to remedy. If you cannot fulfill the requirement nor obtain an accommodation within 30 days, your offer will be rescinded.