Clinical Pharmacist

The Role
The Clinical Pharmacist- Commercial is primarily responsible for oversight/support of the formulary offerings, utilization management protocols, and related clinical programs.

This role leverages clinical expertise and a strong understanding of managed care to develop, implement, and administer formulary, pharmacy medical policies for cell & gene therapies and clinical management strategies to support clinical and financial goals. This pharmacist also serves as the Subject Matter Expert and primary point of contact for medical cost trend management, cell& gene therapy program, and the real-world evidence study program.

The Team
As an integral part of the Pharmacy department, the Clinical Pharmacist collaborates within the broader Pharmacy team, with our PBM, vendor partners Evio and Synergie, within the HMM division, and cross-functionally with Sales, Underwriting, Actuarial, Product, and others.

This role is eligible for our Flex persona.

Key Responsibilities:

• Actively lead or participate in the strategic planning, development, and implementation of clinically appropriate and cost-effective programs to help control trend and drive positive clinical outcomes. This includes tracking drug pipeline activity to proactively identify clinical management opportunities.
• Collaborate with other business areas to effectively implement and support ongoing maintenance of clinical strategies such as medical cost trend management and rebate strategy, cell & gene outcomes-based contracts and tracking strategies, real world evidence study deployment and program management.
• Provide ongoing evaluation of recommendations resulting from real world evidence studies, medical pharmacy utilization trends and resultant clinical initiatives to ensure objectives are met.
• Serve as the Subject Matter Expert and primary point of contact for medical cost trend management rate reviews, real world evidence program, cell & gene therapy pipeline and trend; assist with ad hoc clinically focused requests from internal business areas, providers, accounts, and members.
• Primary support of corporate innovation initiatives with external partners such as Evio and Synergie as needed.

Key Qualifications:

• Excellent written and oral communication skills including ability to present to senior leaders and to external audiences
• Strong interpersonal skills with demonstrated ability to establish and maintain positive, effective working relationships with staff, internal, and external customers
• Superb organizational and time management skills, ability to work independently and effectively prioritize multiple projects and assignments
• Demonstrated strength in analysis, identification of problems, and issue resolution
• Excellent skills in teamwork and team approaches to goal setting and attainment, results oriented

Education and Experience:

• Minimum of professional Registered Pharmacist degree required. Graduate study in business, public health, or health policy fields will be favorably considered.
• Unrestricted current and valid license to practice pharmacy in the state of Massachusetts
• Experience in a managed care setting, either from the provider, the payer, or the PBM side of the industry, is required.
• 2-5 years prior pharmacy management experience preferred

#LI-HYBRID

High school degree or equivalent required unless otherwise noted above

The job posting range is the lowest to highest salary we in good faith believe we would pay for this role at the time of this posting. We may ultimately pay more or less than the posted range, and the range may be modified in the future. An employee's pay position within the salary range will be based on several factors including, but limited to, relevant education, qualifications, certifications, experience, skills, performance, shift, travel requirements, sales or revenue-based metrics, and business or organizational needs and affordability.

This job is also eligible for variable pay.

We offer comprehensive package of benefits including paid time off, medical/dental/vision insurance, 401(k), and a suite of well-being benefits to eligible employees.

Note: No amount of pay is considered to be wages or compensation until such amount is earned, vested, and determinable. The amount and availability of any bonus, commission, or any other form of compensation that are allocable to a particular employee remains in the Company's sole discretion unless and until paid and may be modified at the Company's sole discretion, consistent with the law.

WHY Blue Cross Blue Shield of MA?

We understand that theconfidence gapandimposter syndromecan prevent amazing candidates coming our way, so please don't hesitate to apply. We'd love to hear from you. You might be just what we need for this role or possibly another one at Blue Cross Blue Shield of MA. The more voices we have represented and amplified in our business, the more we will all thrive, contribute, and be brilliant. We encourage you to bring us your true colors, , your perspectives, and your experiences. It's in our differences that we will remain relentless in our pursuit to transform healthcare for ALL.

As an employer, we are committed to investing in your development and providing the necessary resources to enable your success. Learn how we are dedicated to creating an inclusive and rewarding workplace that promotes excellence and provides opportunities for employees to forge their unique career path by visiting ourCompany Culturepage. If this sounds like something you'd like to be a part of, we'd love to hear from you. You can also join ourTalent Communityto stay "in the know" on all things Blue.

At Blue Cross Blue Shield of Massachusetts, we believe in wellness and that work/life balance is a key part of associate wellbeing. For more information on how we work and support that work/life balance visit our "How We Work" Page.