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Pharmacist, Business Segment Director - Commercial Markets (Self Insured)

Hybrid | Eagan, Minnesota
Job ID: R0004827 Career Area: Health Services Date Posted: 08/19/2024
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About Blue Cross

Blue Cross and Blue Shield of Minnesota is one of the most recognized and trusted health care brands in the world with 2.5 million members. We’re committed to reinventing health care to improve health for our members and the community. We hope you'll join us.

How Is This Role Important to Our Work?

The Pharmacist, Business Segment Director manages all aspects of assigned business segment(s) and working with the Pharmacy Department to provide hands-on support, consultation, technical and clinical expertise. This will include coordination of the clinical components of the pharmacy program and represent the Pharmacy department at various teams and committees throughout the organization requiring clinical pharmacy expertise. The individual may develop and manage one or more direct reports and liaise with the pharmacy benefit manager (PBM) and other program vendors to coordinate activities and program interventions of the clinical pharmacists assigned to the health plan. This role plays a critical role in supporting the strategic and operational objectives of the Pharmacy Department.

A Day in the Life:

  • Manage all aspects, including financial/operational performance of assigned business segment(s).

  • Support the Sr. Director Pharmacy in representing the department on clinical pharmacy issues as needed throughout the organization.

  • Represent Pharmacy Department and/or lead clinical pharmacy meetings internally and externally.

  • Point of contact for pharmacy business segment and represent the segment internally and externally, including meetings.

  • Lead projects and program implementation related, but not limited to, disease and/or case management, drug management initiatives, specialty pharmacy, patient safety and clinical outcomes.

  • Lead benefit design strategies for business segment.

  • Pharmacy lead providing strategic direction on commercial membership growth strategies.

  • Oversees the development, execution and operation of programs and services which are clinically effective, manage overall drug costs/trend and create positive member and provider experiences.

  • Apply knowledge and expertise of drugs and therapies covered under medical and pharmacy benefits for clinical program and benefit management.

  • Actively engage with the PBM or vendor clinical team in the design and coordination of clinical program elements including formulary management and utilization management.

  • Provide hands-on consultation to groups, and/or health plan staff regarding appropriate benefit design, clinical outcomes, and cost issues.

  • Monitor and evaluate effectiveness of clinical programs.

  • May manage and provide direction/oversight for other Pharmacy Department staff.

Nice to Have:

  • Masters degree preferred or post graduate training, advanced training, or clinical program completion.

Required Skills and Experiences:

  • Accepting this director level position at BCBSMN requires signing an Employee Confidentiality, Intellectual Property Assignment and Restrictive Covenants Agreement as a condition of employment.

  • Clear and active Pharmacist license in the state of Minnesota.

  • BS degree in Pharmacy or PharmD.

  • 5+ years of related professional experience. All relevant experience including work, education, transferable skills, and military experience will be considered.

  • Excellent verbal and written communication skills.

  • Superior analytical, quantitative, and problem-solving skills.

  • Strong business acumen.

  • Proficient and confident conducting discussions in front of large and small groups.

  • Ability to manage/lead one or several direct reports.

  • Some travel may be required within local market.

Make A Difference

Blue Cross is an Equal Opportunity and Affirmative Action employer that values diversity. All qualified applicants will receive consideration for employment without regard to, and will not be discriminated against based on race, color, creed, religion, sex, national origin, genetic information, marital status, status with regard to public assistance, disability, age, veteran status, sexual orientation, gender identity, gender expression, or any other legally protected characteristic.

Reasonable Accommodation for Job Seekers with a Disability: If you require reasonable accommodation in completing this application, interviewing, completing any pre-employment testing, or otherwise participating in the employee selection process, please direct your inquiries to talent.acquisition@bluecrossmn.com.

All roles require a high school diploma (or equivalency) and legal authorization to work in the U.S.

Blue Cross® and Blue Shield® of Minnesota and Blue Plus® are nonprofit independent licensees of the Blue Cross and Blue Shield Association.
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