Manager - Pharmacy Clinical Programs

Employment Type

: Full-Time

Industry

: Miscellaneous



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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!

Who We Are: A Customer-Focused, Local Health Plan

The customer is the center of all we do. We deliver drug management programs, solutions, and services that hold the healthcare system accountable to standards of care, quality, and clinical effectiveness. Our programs and solutions deliver value to customers and strive to improve member experience to make their experience simple and easy. Premera is dedicated to training early in career Pharmacy professionals, one of our goals is to develop the next generation of Pharmacists and such our residency program and paired relationship with the University of Washington provides additional learning opportunities, including precepting APPE students, and participating in health outcomes research.

TheManager Pharmacy Clinical Programs develops, implements, and communicates pharmacy strategy and programs to ensure the clinically appropriate and cost-effective use of medication aligns with and supports Premera's clinical and financial goals. Individual must be able to work effectively across the company with multiple stakeholders and will have direct management of people responsibilities. This role will also manage our pharmacy residency program. Our program approaches integrated medical and pharmacy benefits with a holistic view of our customer’s health. We offer a variety of experiences across the company to deliver a comprehensive learning experience.

What you'll do:

Develop and execute short term and long term pharmacy clinical strategy, and provide subject matter expertise on the strategic direction of Premera's Pharmacy Programs for both commercial and government (i.e. Individual Marketplace, Medicare Part D) lines of business; make recommendations and execute on corporate-wide Pharmacy initiatives, such as: Drug Utilization Management across Medical and Pharmacy benefit, Formulary Program and Formulary Promotions, including oversight of Pharmacy and Therapeutics (P&T) Committee, Specialty Pharmacy Program and other clinical programs focused on management of chronic conditions, optimizing drug management or adherence
Create, implement, and manage clinical drug utilization programs and capabilities.
Responsible for hiring, performance management, training, and professional development of team.
Manage and lead development of clinical pharmacy strategy and programs that may include: Integrated Medical Policies for drugs across Medical and Pharmacy benefit, provider consulting, pipeline management, Pharmacy Residency program, rebate solutions across Medical and Pharmacy benefit and quality measure improvement efforts, including programs to support NCQA HEDIS, Medicare Star Rating and Quality Rating System performance improvement efforts.
Provide clinical pharmacy expertise and guidance to internal and external stakeholders including Provider and Customer Engagement team, Sales, Marketing and Quality.
Produce and analyze pharmacy cost trends, clinical and managed care presentations and Pharmacy communication materials for designated market geographies.
Support Pharmacy benefit design development in collaboration with Product Services, Actuary, and the Pharmacy Benefit Manager partner.

What you'll bring:

Pharmacist with an active Washington State Pharmacist License
Master’s Degree
Board Certification by the Board of Pharmacy Specialists (BCPS)
6 years of experience in clinical program development/management in a managed care setting.

Preferred incumbents will have completed American Society of Health-System Pharmacists ASHP-accredited residency program, and has experience in a managed care pharmacy. Experience with project management, managing teams, Medicare, and Health Benefit Exchanges is also preferred.

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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.

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