Director, Pharmacy - Drug Quality Program
About The Position
The Director, Pharmacy - Drug Quality Program works within the Clinical Pharmacy Programs team in the Pharmacy Strategy & Operations department. The team defines and executes strategies addressing the clinical quality and affordability of prescription medications used by Blue Shield of California members. The Director is responsible for performance on quality measures concerning medication safety, health outcomes, and member experience accessing needed prescription drugs. The role reports to the Senior Director, Clinical Pharmacy Programs. The position collaborates with enterprise partners to improve drug-related quality and member experience strategies, including Medicare Part D Star Ratings measures and measures for non-Medicare members. It oversees data-driven assessment of performance factors and outcomes, reporting to stakeholders and executives, and manages a multi-channel roadmap of programs aligned with clinical strategy, enterprise goals, and regulatory and accreditation requirements. The Director also advances technology and vendor capabilities, identifies industry best practices, leads employee engagement and team performance efforts, and serves as a key leadership stakeholder in Pharmacy operations, benefit and formulary design, and drug utilization management. This is a hybrid role. For most teams, the workplace model generally requires in-office work two days per week. Employees living more than 50 miles from an office location work with their manager to determine in-office time based on business need. The work takes place in an office and work-from-home desk environment, with sedentary activity for most of the workday.
Requirements
- Doctor of Pharmacy (PharmD) degree from an accredited U.S. school of pharmacy.
- 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 pharmacy claims data and designing key performance metrics.
- Advanced computer skills, including Microsoft applications.
Responsibilities
- Collaborate with enterprise business partners to continuously improve strategies addressing drug-related quality and member experience measures, including Medicare Part D Star Ratings measures and measures for 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 enable strong 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 the Director’s team.
- Serve as a key leadership stakeholder in Pharmacy operations, benefit and formulary design, and drug utilization management.
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What This Job Offers
Job Type
Full-time
Career Level
Director
Education Level
Ph.D. or professional degree
