Program Manager, Consultant- Pharmacy Benefits Management

Blue Shield of CaliforniaLong Beach, CA
Hybrid

About The Position

The Pharmacy Operations and Stabilization team provides management and end-to-end oversight of all Pharmacy operations, production stabilization issues, and drives issues from identification to resolution within a matrixed environment. The Program Manager, Consultant will report to the Sr Manager, Pharmacy Operations and Stabilization. In this role you will assure timely and accurate operations for your assigned areas, lead intake and initial assessment of new pharmacy issues, partner with subject matter experts to perform root cause analysis, identify impacts and potential solution options, develop and drive the summary and action plan including any remediation needed for medium to large issues impacting Pharmacy Strategy and Operations. Working in a matrixed environment, the Program Manager, Consultant will partner with cross-functional teams and external vendor partners to ensure alignment with stakeholders. Our leadership model is about developing great leaders at all levels and creating opportunities for our people to grow – personally, professionally, and financially. We are looking for leaders that are energized by creative

Requirements

  • Requires a Bachelors degree or equivalent experience
  • 7 years of prior relevant experience required
  • Advanced knowledge of pharmacy operations at the health plan level including benefit build and adjudication and/or claims/financial data exchange
  • Excellent analytical and problem-solving skills
  • Excellent interpersonal, verbal and written communication skills that exhibit a solutions-oriented approach
  • Demonstrated leadership, project management, and executive level reporting experience
  • Experience using MS Office tools including Excel, PowerPoint, SharePoint and Project

Responsibilities

  • Assure consistent, accurate, timely and compliance execution of assigned operational functions
  • Provide subject matter expertise and management of assigned operational functions
  • Provide overall program leadership, guidance, and manage all aspects of a given program, including requirements gathering, business case creation, and implementation
  • Develop resourcing strategies to ensure optimum support for projects and for the day-to-day operational activities
  • Lead cross-functional meetings and foster teamwork; drive escalation and resolution of issues, while promoting collaboration and coordination across broad categories of stakeholders
  • Lead intake efforts and perform initial assessment of new medium to large pharmacy production stabilization issues
  • Own, manage, and oversee the end-to-end activities associated with resolving the medium to large pharmacy production stabilization issues assigned to you
  • Develop a summary and action plan including root cause analysis, solution options, remediation efforts, and a timeline for resolution of each pharmacy issue
  • Develop and drive a resolution plan for highly matrixed and complex pharmacy production stabilization issues
  • Develop and distribute executive summary reports to keep key stakeholders informed of status and progress
  • Other duties as assigned
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