Job Description
Job Description Your Role The Pharmacist, Principal, Formulary and Pharmacy & Therapeutics (P&T) reports to the Senior Manager of Pharmacy & Therapeutics. The Pharmacist, Principal is responsible for development of drug and drug class reviews by researching clinical evidence and guidelines, analyzing data including comparative effectiveness and budget impact data to support clinically appropriate and cost-effective formulary management of drugs. In this role, you will collaborate with stakeholders to develop, coordinate, and evaluate pharmacoeconomic outcomes and value-based assessments to support formulary decision making. This role works with Clinical Pharmacists and others to support Blue Shield of California's mission and strategy.
Responsibilities Your Work In this role, you will:
- Facilitate formulary development and provide P&T clinical support based on scientific evidence and standards of practice, including assessing peer-reviewed literature, pharmacoeconomic studies, outcomes research data [e.g. comparative effectiveness research (CER)], and budget impact assessments
- Collaborate with the analytics team to develop pharmacoeconomic analyses and complete outcomes research and make recommendations to management and P&T to support cost effective formulary management
- Develop and analyze prescription drug and medical claims data reports to identify opportunities to improve quality and cost-effective use of drugs
- Regularly assess the medical evidence to ensure medications are utilized appropriately through the annual medication review process
- Collaborate with management and cross-functional teams to create a plan for maintaining development and implementation of a value-based formulary design, including P&T process changes to support value-based formulary decisions
- Prepare client-facing clinical summaries supporting documentation and reports
- Lead communication efforts about clinical value propositions across therapeutic areas
- Perform retrospective data analysis and healthcare cost analysis for formulary decision and formulary maintenance to manage cost of healthcare
- Conduct presentations at formulary meetings, P&T committees, and drug utilization review (DUR) meetings
- Work independently and collaboratively with multidisciplinary/cross-functional teams with minimal oversight and direction from the Manager
Qualifications Your Knowledge and Experience - Requires a Doctor of Pharmacy (PharmD) degree
- Requires a currently active and unrestricted California Registered Pharmacist (RPh) license
- Requires 4 years of experience in clinical pharmacy
- Experience working in a managed care setting and direct client and provider interface is preferred
- Demonstrated leadership skills/capabilities
- Thorough clinical knowledge regarding therapeutic use of drugs
- Excellent oral and written communication skills
- Excellent presentation skills
- Strong problem-solving, math, and analytical skills
- Strong project or program management skills
- Ability to work independently and as part of a team (including remotely)
- Proficiency with Microsoft Office applications
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About the Team About Blue Shield of California As of January 2025, Blue Shield of California became a subsidiary of Ascendiun. Ascendiun is a nonprofit corporate entity that is the parent to a family of organizations including Blue Shield of California and its subsidiary, Blue Shield of California Promise Health Plan; Altais, a clinical services company; and Stellarus, a company designed to scale healthcare solutions. Together, these organizations are referred to as the Ascendiun Family of Companies.
At Blue Shield of California, our mission is to create a healthcare system worthy of our family and friends and sustainably affordable. We are transforming health care in a way that genuinely serves our nonprofit mission by lowering costs, improving quality, and enhancing the member and physician experience.
To achieve our mission, we foster an environment where all employees can thrive and contribute fully to address the needs of the various communities we serve. We are committed to creating and maintaining a supportive workplace that upholds our values and advances our goals.
Blue Shield is a U.S. News Best Company to work for, a Deloitte U.S. Best Managed Company and a Top 100 Inspiring Workplace. We were recognized by Fair360 as a Top Regional Company, and one of the 50 most community-minded companies in the United States by Points of Light. Here at Blue Shield, we strive to make a positive change across our industry and communities - join us!
Our Values: - Honest. We hold ourselves to the highest ethical and integrity standards. We build trust by doing what we say we're going to do and by acknowledging and correcting where we fall short.
- Human. We strive to listen and communicate effectively, showing empathy by understanding others' perspectives.
- Courageous. We stand up for what we believe in and are committed to the hard work necessary to achieve our ambitious goals.
Our Workplace Model We believe in fostering a workplace environment that balances purposeful in-person collaboration with flexibility - providing clear expectations while respecting the diverse needs of our workforce. Our workplace model is designed around intentional in-person interaction, collaboration, connection, creativity and flexibility:
- For most teams, this means coming into the office two days per week.
- Employees living more than 50 miles from an office location, out of state employees, and employees in certain member-facing roles should work with their manager to determine in-office time based on business need.
- For employees with medical conditions that may impact their ability to work in-office, we are committed to engaging in an interactive process and providing reasonable accommodations to ensure their work environment is conducive to their success and well-being.
The Company reserves the right to require more presence in the office based on business needs, and requirements are subject to change with periodic reviews.
Physical Requirements: Office Environment - roles involving part to full time schedule in Office Environment. Based in our physical offices and work from home office/deskwork - Activity level: Sedentary, frequency most of work day.
Please click here for further physical requirement detail.
Equal Employment Opportunity: External hires must pass a background check/drug screen. Qualified applicants with arrest records and/or conviction records will be considered for employment in a manner consistent with Federal, State and local laws, including but not limited to the San Francisco Fair Chance Ordinance. All qualified applicants will receive consideration for employment without regards to race, color, religion, sex, national origin, sexual orientation, gender identity, protected veteran status or disability status and any other classification protected by Federal, State and local laws.
Job Tags
Full time, Part time, Work at office, Local area, Remote work, Work from home, Home office, 2 days per week