Your Role
The Pharmacy Services Prior Authorization team conducts medical necessity reviews for drug coverage. The Pharmacist Manager will report to the Pharmacist Senior Manager, Pharmacy Benefit Prior Authorization. In this role, you will support the Blue Shield of California Pharmacy and Therapeutics (P&T) Committee process by ensuring that evidence-based clinical decisions are implemented operationally to support safe, efficacious, and cost-effective prescribing of medications. 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 and critical thinking, building and sustaining high-performing teams, getting results the right way, and fostering continuous learning.s the right way, and fostering continuous learning.
Your Work
In this role, you will:
- Provide oversight for the management of program area operations and employees
- Be responsible for promotion and execution of overall vision, goals, objectives of the business unit
- Provide oversight for the coordination of activities of the program area with other business units and monitor operational statistics to ensure all respective accreditation, regulatory and compliance requirements are met
- Provide oversight for the development, implementation, coordination, and assessment of programs to improve quality and cost-effectiveness
- Demonstrate leadership principles daily and ensure team actions are in place to make Blue Shield a great place to work
- Regularly monitor program data and metrics to evaluate program effectiveness and outcomes; reports to appropriate committees, managers, and other internal or external stakeholders
- Support other teams within and outside of the Pharmacy Services department with subject matter expertise
- Precept Pharmacy Practice Residents and students, as assigned. Maintain required residency program documentation and meet standards for preceptorship.
Your Knowledge and Experience
- Requires a Doctor of Pharmacy (PharmD) degree
- Requires at least 5 years of experience in a managed care setting, including at least 3-5 years of management experience or equivalent
- Requires an active and unrestricted California Registered Pharmacist (RPh) license
- Demonstrates thorough knowledge regarding therapeutic use of drugs
- Understands basic management approaches such as work scheduling, prioritizing, coaching and process execution, work organization, risk management and delegation
- Experience in leading and managing the execution of processes, projects, and tactics
- Demonstrates critical thinking and effective decision-making
- Advanced skills analyzing data to make business decisions
Pay Range:
The pay range for this role is: $ 118800.00 to $ 178200.00 for California.
Note:
Please note that this range represents the pay range for this and many other positions at Blue Shield that fall into this pay grade. Blue Shield salaries are based on a variety of factors, including the candidate's experience, location (California, Bay area, or outside California), and current employee salaries for similar roles.
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