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Blue Shield

Trade Relations, Principal

Blue Shield, Long Beach, California, us, 90899


Your Role

The Trade Relations team is responsible for managing the trade relations function of the company in accordance with the policies and practices of Blue Shield of California. The Trade Relations, Principal will report to the Senior Director of Trade Relations. In this role you will work with internal trade partners and clients to support BSC’s Pharmacy Care Reimagined initiative in providing members with convenient, transparent access to medications while lowering costs.

Your Work

In this role, you will:

Develop, analyze and monitor prescription drug, medical claims, and program data to identify opportunities to improve quality and cost of healthcare and to monitor/report performance and outcomes

Develop project proposals for identified opportunities and support implementation

Serve as a Blue Shield of California contact and subject matter expert to stakeholders, and manage external relationships (vendors, manufacturers, clients) related to assigned work

Develop and manage overall contracting strategy (negotiation, review, and execution of contracts) for all lines of business

Develop alternative payment model (e.g. value-based and outcomes-based contracts)

Manage medical rebate contracts

Monitor the impact of preferred drug list on existing negotiations and forecast future contract strategies

Analyze the impact of client formulary choices with respect to rebate impact; provide rebate status information to clients as requested

Collaborate with internal partners on contract impact, and provide timely coordination for Pharmacy and Therapeutics review of formularies, posting, and eventual confirmation to the drug manufacturer

Responsible for timely and accurate maintenance of intricate data sets used for client rebate packages, billing sheets, and any additional supporting documentation

Understand and negotiate adjusted rebate minimum guarantee

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