Blue Shield Of California
Pharmacy Pricing Manager, Consultant
Blue Shield Of California, Oakland, California, United States, 94616
Job Description
Your Role
The Pharmacy Transformation team is a key pillar in Blue Shield's Pharmacy Reimagined strategy bringing easy, affordable, and transparent pharmacy care to our members. The Drug Pricing Manager, Consultant, will report to the Director of Pharmacy Pricing & Growth. In this role you will help to grow the business through competitive, strategic pricing, maximizing the profitability and market access of pharmaceutical products and effectively manage $5+ billion in pharmacy spend. 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.
Responsibilities
Your Work
In this role, you will:Build/enhance a complex client-level pharmacy pricing model to ensure accurate and flexible financial analysis to assess the impact of pricing changes on revenue, margins and overall business performanceTake pricing tools and apply them to customer specific utilization while balancing multiple strategies, market competitiveness, membership, and profitability goals, making adjustments as necessary to respond to market changes.Be able to change financial projections based on data driven information to allow expedient decision-makingSupport Sales partners and client/prospect bids with pricing guidance and pharmacy subject matter expertiseLeverage knowledge of industry trends, available solutions, and vendor differentiators to develop and implement innovative pricing strategiesAnalyze large drug claims datasets to estimate the financial impact of various contracts and conduct market research to understand pricing trends and competitor pricing to support vendor contract negotiations to secure favorable termsReview client contractual terms around all financial elements to ensure language minimizes Blue Shield risk while maintaining client value; regularly review templates and adjust for new pricing strategies or market eventsEnsure pricing strategies comply with legal, regulatory, and payer requirements, including guidelines from government agencies like FDA or CMSCross-functional collaboration to align pricing strategies; Provide pricing knowledge sharing, education, advice and coaching to other colleagues and departmentsQualifications
Your Knowledge and Experience
Bachelor's degree (or equivalent work experience) with 5+ years' experience in pharmacy pricing/underwriting/modelingDeep understanding of pharmacy benefit management including retail/mail/specialty financials, manufacturer rebates, and alternate or non-conventional pricing structuresExcellent Microsoft Excel skillsExperience supporting financial aspects of competitive RFPs and contract negotiationsPay Range:
The pay range for this role is: $ 109120.00 to $ 163680.00 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.
About the Team
Blue Shield of California's mission is to ensure all Californians have access to high-quality health care at a sustainably affordable price. 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 fulfill our mission, we must ensure a diverse, equitable, and inclusive environment where all employees can be their authentic selves and fully contribute to meet the needs of the multifaceted communities we serve. Our continued commitment to diversity, equity, and inclusion upholds our values and advances our goal of creating a healthcare system that is worthy of our family and friends while addressing health disparities, promoting social justice, and integrating health equity through our products, business practices, and presence as a corporate citizen.
Blue Shield has received awards and recognition for being a certified Fortune 100 Best Companies to Work, Military Friendly Employer, People Companies that Care, a Leading Disability Employer, and one of California's top companies in volunteering and giving. 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 be our authentic selves, listening and communicating effectively, and showing empathy towards others by walking in their shoes.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:
Blue Shield of California is dedicated to making work-life balance a reality. Whether you prefer to work in an office or from home, we understand flexibility is more important than ever. That's why Blue Shield is a hybrid company, offering you the opportunity to decide where you can do your best and most meaningful work.
Two ways of working: Hybrid (our default) and office
Hybrid - In a business unit approved office a few times per year to 3 days per week, on averageOffice - In a business unit approved office 4+ days a week, on average. If the role you're applying for is deemed an "Essential Role," the company has determined that the role can only be performed in a Blue Shield office or in the field and would require your to meet the office worker classification.
Physical Requirements:
Office Environment - roles involving part to full time schedule in Office Environment. Due to the current public health emergency in California, Blue Shield employees are almost all working remotely. 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.
Your Role
The Pharmacy Transformation team is a key pillar in Blue Shield's Pharmacy Reimagined strategy bringing easy, affordable, and transparent pharmacy care to our members. The Drug Pricing Manager, Consultant, will report to the Director of Pharmacy Pricing & Growth. In this role you will help to grow the business through competitive, strategic pricing, maximizing the profitability and market access of pharmaceutical products and effectively manage $5+ billion in pharmacy spend. 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.
Responsibilities
Your Work
In this role, you will:Build/enhance a complex client-level pharmacy pricing model to ensure accurate and flexible financial analysis to assess the impact of pricing changes on revenue, margins and overall business performanceTake pricing tools and apply them to customer specific utilization while balancing multiple strategies, market competitiveness, membership, and profitability goals, making adjustments as necessary to respond to market changes.Be able to change financial projections based on data driven information to allow expedient decision-makingSupport Sales partners and client/prospect bids with pricing guidance and pharmacy subject matter expertiseLeverage knowledge of industry trends, available solutions, and vendor differentiators to develop and implement innovative pricing strategiesAnalyze large drug claims datasets to estimate the financial impact of various contracts and conduct market research to understand pricing trends and competitor pricing to support vendor contract negotiations to secure favorable termsReview client contractual terms around all financial elements to ensure language minimizes Blue Shield risk while maintaining client value; regularly review templates and adjust for new pricing strategies or market eventsEnsure pricing strategies comply with legal, regulatory, and payer requirements, including guidelines from government agencies like FDA or CMSCross-functional collaboration to align pricing strategies; Provide pricing knowledge sharing, education, advice and coaching to other colleagues and departmentsQualifications
Your Knowledge and Experience
Bachelor's degree (or equivalent work experience) with 5+ years' experience in pharmacy pricing/underwriting/modelingDeep understanding of pharmacy benefit management including retail/mail/specialty financials, manufacturer rebates, and alternate or non-conventional pricing structuresExcellent Microsoft Excel skillsExperience supporting financial aspects of competitive RFPs and contract negotiationsPay Range:
The pay range for this role is: $ 109120.00 to $ 163680.00 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.
About the Team
Blue Shield of California's mission is to ensure all Californians have access to high-quality health care at a sustainably affordable price. 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 fulfill our mission, we must ensure a diverse, equitable, and inclusive environment where all employees can be their authentic selves and fully contribute to meet the needs of the multifaceted communities we serve. Our continued commitment to diversity, equity, and inclusion upholds our values and advances our goal of creating a healthcare system that is worthy of our family and friends while addressing health disparities, promoting social justice, and integrating health equity through our products, business practices, and presence as a corporate citizen.
Blue Shield has received awards and recognition for being a certified Fortune 100 Best Companies to Work, Military Friendly Employer, People Companies that Care, a Leading Disability Employer, and one of California's top companies in volunteering and giving. 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 be our authentic selves, listening and communicating effectively, and showing empathy towards others by walking in their shoes.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:
Blue Shield of California is dedicated to making work-life balance a reality. Whether you prefer to work in an office or from home, we understand flexibility is more important than ever. That's why Blue Shield is a hybrid company, offering you the opportunity to decide where you can do your best and most meaningful work.
Two ways of working: Hybrid (our default) and office
Hybrid - In a business unit approved office a few times per year to 3 days per week, on averageOffice - In a business unit approved office 4+ days a week, on average. If the role you're applying for is deemed an "Essential Role," the company has determined that the role can only be performed in a Blue Shield office or in the field and would require your to meet the office worker classification.
Physical Requirements:
Office Environment - roles involving part to full time schedule in Office Environment. Due to the current public health emergency in California, Blue Shield employees are almost all working remotely. 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.