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Premera Blue Cross Pharmacy Manager, Trend Management and Clinical Consulting in Spokane, Washington

Join Our Team: Do Meaningful Work and Improve People’s Lives

Our purpose, to improve customers’ lives by making healthcare work better, is far from ordinary. And so are our employees. Working at Premera means you have the opportunity to drive real change by transforming healthcare.

To better serve our customers, we’re creating a culture that promotes employee growth, collaborative innovation, and inspired leadership. We are committed to creating an environment where employees can do their best work and where best-in-class talent comes, stays, and thrives!

COVID-19 Vaccination Policy:

On September 9 2021, President Joe Biden issued an executive order requiring the vaccination of employees at federal contractors. Premera Blue Cross, as a health plan within the federal employee benefits program, is designated as a federal contractor. Premera has implemented a new requirement for all employees, including telecommuters, to either show proof of being fully vaccinated from COVID-19 or have an approved medical or religious accommodation (based on a disability/medical condition or sincerely held religious belief), by January 1, 2022. From the onset of the pandemic, Premera has remained committed to the health and well-being of our employees, customers and communities.

As a new employee you will be required to show proof of being fully vaccinated within your first five days of employment or request an accommodation prior to your start date.

The Pharmacy Manager, Trend Management and Clinical Consulting oversees a team made up of Pharmacists and Nurses responsible for managing client and sales relationships, providing clinical consulting on medication utilization levers (base benefit, formulary, UM options), responding to RFP questions and supporting special projects as assigned in support of Premera's clinical and financial goals.

The position is responsible for ensuring we have consistent and clear market facing messaging to deliver on the strategic direction of Premera's Pharmacy Programs. The position collaborates and works closely with various Premera Departments including, Sales, Underwriting, Marketing and Government Programs.

This role also supports ongoing drug trend (usage and cost) monitoring, management and reporting as well as the development of the ongoing improvement strategy of Premera’s pharmacy clinical programs and evolution of drug trend management approach. Ideally this candidate will have a working knowledge of Care Management including case management and medical utilization management.

If you are a pharmacist with an advanced degree with six years of pharmacy experience with at least two of those years focused on clinical program development and/or client consultation at a Pharmacy Benefit Manager (PBM) or health plan this is the role for you! You must be able to communicate effectively verbally and in writing with strong presentation skills and have the proven ability to build and maintain relationships with both internal and external facing individuals.

What you'll do:

  • Oversee day to day activities of the team, including staff management, achieving department goals and team effectiveness.

  • Ensure clinical programs, operations and consulting focus effectively delivers on the strategic direction of Premera's Pharmacy Program while meeting the needs of customers.

  • Develop and maintain monitoring and ongoing improvement strategy for pharmacy clinical programs, operations, or consulting. Areas of focus may include: Drug Utilization Management/Prior Authorization across Medical and Pharmacy benefit, Quality accreditation reporting and documentation and required procedures for pharmacy. Pharmacy benefit manager (PBM) and other vendor set-up, testing and issue resolution Specialty pharmacy set-up, testing and escalated specialty pharmacy customer issues. Formulary Program and Formulary Promotions, including oversight of Pharmacy and Therapeutics (P&T) Committee

  • Responsible for hiring, performance management, training, and professional development of team.

  • Provide clinical training, and business support of pharmacy and medical management strategies and solutions to Sales and Marketing Department including sales of the pharmacy benefit to clients (current and prospective clients)

  • Contribute to and manage completion of pharmacy and clinical/medical management content in Request for Proposals (RFPs).

What you'll bring:

  • Pharmacist with an advanced degree (e.g. PharmD, MBA, MHA, MPH) (Required)

  • Active state Pharmacist License (Required)

  • Six (6) years’ of pharmacy experience with at least two (2) years’ experience focused in any combination of the following: clinical program development, pharmacy consulting experience working in a Pharmacy Benefit Management (PBM) or in a health plan. (Required)

  • Preferred incumbents will have completed American Society of Health-System Pharmacists ASHP-accredited residency program

  • Experience with project management

  • Experience in a managed care pharmacy

What we offer

  • Medical, vision and dental coverage

  • Life and disability insurance

  • Retirement programs (401K employer match and pension plan)

  • Wellness incentives, onsite services, a discount program and more

  • Tuition assistance for undergraduate and graduate degrees

  • Generous Paid Time Off to reenergize

  • Free parking

Equal employment opportunity/affirmative action:

Premera is an equal opportunity/affirmative action employer. Premera seeks to attract and retain the most qualified individuals without regard to race, color, religion, sex, national origin, age, disability, marital status, veteran status, gender or gender identity, sexual orientation, genetic information or any other protected characteristic under applicable law.

If you need an accommodation to apply online for positions at Premera, please contact Premera Human Resources via email at careers@premera.com or via phone at 425-918-4785.

At Premera, we make healthcare work better. By focusing on improving our customers’ experience purposefully and serving their needs passionately, we make the process easier, less costly, and more positive. Through empathy and advocacy, we change lives.

As the leading health plan in the Pacific Northwest, we provide comprehensive health benefits and services to more than 2 million customers, from individuals to Fortune 100 companies. Our services include innovative programs focused on health management, wellness, prevention, and patient safety. We deliver these programs through health, life, vision, dental, disability, and other related products and services.

Premera Blue Cross is headquartered in Mountlake Terrace, WA, with operations in Spokane and Anchorage. The company has operated in Washington since 1933 and in Alaska since 1952. With more than 80 years of experience in the region, we deliver innovation, choice, and expertise.

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