AVP, Chief Pharmacy Officer

BlueCross BlueShield of South Carolina•Columbia, SC

34d•Onsite

About The Position

Why should you join the BlueCross BlueShield of South Carolina family of companies? Other companies come and go, but we've been part of the national landscape for more than seven decades, with our roots firmly embedded in the South Carolina community. We are the largest insurance company in South Carolina … and much more. We are one of the nation's leading administrators of government contracts. We operate one of the most sophisticated data processing centers in the Southeast. We also have a diverse family of subsidiary companies, allowing us to build on various business strengths. We deliver outstanding service to our customers. If you are dedicated to the same philosophy, consider joining our team! Position Purpose: As AVP, Chief Pharmacy Officer, you will be responsible for overseeing all BlueCross and BlueChoice private business commercial, exchange and Medicaid pharmacy formularies and related clinical program initiatives. You will lead and direct the development and execution of formulary and clinical strategies for delivering pharmacy services. In this role, the AVP, Chief Pharmacy Officer will foster strong relations with internal departments and external providers and serves as pharmacy subject matter expert on a variety of commercial and government internal and external committees and workgroups. Description Location: This position is full-time (40-hours/week) Monday-Friday ON-SITE at our 4101 Percival Road, Columbia, SC 29229 location.

Requirements

Bachelor's degree in a job related field.
10+ years progressively responsible experience in the management of pharmacy services to include experience in hospital pharmacy setting and/or managed care experience.
Active unrestricted Pharmacy licensure in state hired.

Nice To Haves

Practice experience working in a health plan pharmacy services, managed care pharmacy environment, and/or retail or hospital pharmacy service.
Experience with financial aspects of pharmacy agreements including underwriting and structuring of deals.
Experience with pharmacy services and pharmacy benefit management (PBM) contracting for delegated functions and services.
Experience managing pharmacy teams or staff.
Executive level presentation skills.

Responsibilities

Directs, manages, and oversees all aspects of private business commercial and government pharmacy formulary and related clinical program initiatives.
Leads and directs the development and execution of clinical management strategies for delivering pharmacy services.
Develops pharmaceutical guidelines including but not limited to preferred drug lists, utilization management, formulary management, benefits management, and benefit designs.
Directs pharmacy services rendered by PBMs, such as claims processing, PDL management, UM, and pharmacy trend.
Oversees formulary management function.
Fosters strong relations with internal departments and external providers and serves as pharmacy subject matter on a variety of commercial and government internal and external committees and workgroups.
Provides pharmacy support and documentation for contracting determinations.
Evaluates customer requests and individual line of business needs.
Coordinates proposal and grants requests for new pharmacy offerings.
Reviews and adjusts contract to exclude no value added drugs.
Coordinates with provider contracting on the pricing/fee schedules, and evaluates the impact to the network.
Works directly with legal department on contractual language.
Anticipates and responds to the needs of the customer organization related to pharmacy programs and facilitates the successful implementation of the program and retention of the customer.
Leads the development of policies and procedures to ensure compliance with all corporate and government regulations.
Responsible for assessing external pharmacy industry trends and developments that represent risk and opportunities for the organization.
Develops short and long term plans to respond to potential risks and to capitalize on opportunities.
Engages with senior leaders and key stakeholders to ensure the optimal utilization of technology and resources, to support the implementation of enterprise-wide pharmacy systems and processes.
Directs the evaluation and refinement of the pharmacy program and related services provided by internal and external departments/entities.
Ensures compliance with clinical goals of all pharmacy programs.
Directs cost and benefits analysis for drugs, and evaluates the effectiveness of the programs and modifies programs as needed to achieve desired results in collaboration with pharmacy area leaders.
Reviews prescribing guidelines and maintains expertise related to medications and best practices.
Stays informed of additions and changes to medication options, release of generics, changes to prescribing guidelines and all other medical/clinical knowledge required.
Contributes to the development of the clinical mission of pharmacy programs, including the development, implementation, and evaluation of clinical/medical aspects of pharmacy related initiatives.
Monitors department performance and productivity.
Manages budget to ensure cost effectiveness and performance quality.
Assists marketing team with oversight of various materials and other required notifications.