Pharmacy Pricing Manager, Consultant

Your Role

The Pharmacy Transformation team is a key pillar in Blue Shields 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.

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 performance
• Take 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-making
• Support Sales partners and client/prospect bids with pricing guidance and pharmacy subject matter expertise
• Leverage knowledge of industry trends, available solutions, and vendor differentiators to develop and implement innovative pricing strategies
• Analyze 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 terms
• Review 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 events
• Ensure pricing strategies comply with legal, regulatory, and payer requirements, including guidelines from government agencies like FDA or CMS
• Cross-functional collaboration to align pricing strategies; Provide pricing knowledge sharing, education, advice and coaching to other colleagues and departments

Your Knowledge and Experience

• Bachelors degree (or equivalent work experience) with 5+ years experience in pharmacy pricing/underwriting/modeling
• Deep understanding of pharmacy benefit management including retail/mail/specialty financials, manufacturer rebates, and alternate or non-conventional pricing structures
• Excellent Microsoft Excel skills
• Experience supporting financial aspects of competitive RFPs and contract negotiations

Pay 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.