Director, Pharmacy - Drug Quality Program

Blue Shield of California • Oakland, CA

23h • Hybrid

About The Position

The Director, Pharmacy - Drug Quality Program is part of the Clinical Pharmacy Programs team within the Pharmacy Strategy & Operations department at Blue Shield of California. The team defines and executes strategies addressing clinical quality and affordability of prescription medications used by BSC members. Reporting to the Senior Director, Clinical Pharmacy Programs, this role is responsible for performance on quality measures related to medication safety, health outcomes, and member experience accessing needed prescription drugs. The role oversees strategies, programs, performance analysis, technology and vendor capabilities, and stakeholder engagement, while leading teams in alignment with BSC leadership behaviors. The position follows a hybrid workplace model, generally requiring office attendance 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.

Requirements

• Doctor of Pharmacy (PharmD) degree from an accredited school of pharmacy in the United States.
• Current, active, unrestricted California Registered Pharmacist (RPH) license.
• 10 years of prior relevant experience.
• 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 design of key performance metrics.
• Advanced proficiency in computer skills, including Microsoft applications.

Responsibilities

• Collaborate with enterprise business partners to continuously improve strategies for drug-related quality and member experience measures, including Medicare Part D Star Ratings measures and measures applicable to non-Medicare members.
• Oversee assessment of factors affecting quality performance and health outcomes using a results- and data-driven approach; monitor and report program performance to enterprise stakeholders and executives.
• Oversee a multi-lever, multi-channel roadmap and workplan of programs, initiatives, and tactics aligned with BSC’s clinical strategy, enterprise quality and member experience goals, and regulatory and accreditation requirements.
• Drive technology and vendor capabilities that improve operational efficiencies and support high program performance.
• 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 supporting employee engagement and high-performing teams across the business unit and within the team.
• Serve as a key leadership stakeholder in Pharmacy operations, benefit and formulary design, and drug utilization management.
• Supervise, coach, and evaluate direct reports.

What This Job Offers

• Job Type: Full-time
• Career Level: Director
• Education Level: Ph.D. or professional degree