Program Manager, Consultant at Blue Shield of CA in San Francisco, California

Job Description:

Job Summary

The Pharmacy Markets Strategy & Operations area is a key area within Pharmacy Service department with responsibilities to partner with key stakeholders cross-functionally for all lines of business to design and implement Pharmacy Products and market focused initiatives to provide affordable and quality pharmacy benefit coverage and enable membership growth and retention.

Reporting directly to the Senior Manager, Pharmacy Markets Strategy and Operations, the Consultant Program Manager's key responsibilities to support Blue Shield's Individual and Family Plans (IFP) and Medi-Cal lines of business include serving as the pharmacy liaison to drive, monitor and report out pharmacy product and program operational performance for internal and external stakeholders; drive accountability and progress to the pharmacy program operational performance in coordination with pharmacy and other key stakeholders, and leading the program development and implementation of pharmacy benefits/products. This position works closely with other pharmacy teams and cross functionally with other Blue Shield teams. The position may also support other lines of business as appropriate.

The individual may be based in our Oakland, Rancho Cordova, Woodland Hills office or may telecommute. Due to COVID-19 impact and current guidelines, the Consultant Program Manager will onboard and work remotely until Blue Shield resumes work in its office, no earlier than mid-2021.

Responsibilities

• Serve as the primary pharmacy lead on monitoring, reporting, and driving efficiencies for pharmacy program operational performance and excellence for Blue Shield's IFP and Medi-Cal lines of business.


• Drive accountability and support the development of workplans with internal and external stakeholders to ensure progress with the pharmacy program operational performance.


• Drive end-to-end implementation of pharmacy product initiatives/program strategies, including business requirement sessions, product collateral updates and regulatory filings, for annual portfolio refresh.


• Provide support for multiple cross-functional projects simultaneously, establishing work plans and timelines, and leading meetings efficiently to drive consensus among stakeholders.


• Support cross-functional teams on pharmacy technical matters, pharmacy program status or operational day-to-day management inquiries around pharmacy market initiatives, including benefit and product offerings.


• Provide support in the evaluation, assessment and implementation of pharmacy mandates and regulations.


• Other duties as assigned.

Knowledge and Experience

• Bachelors degree and five years working experience of health plan or PBM operational experience required, or an equivalent combination of education and experience.


• Strong program/project management skills, as demonstrated through experience leading and managing complex, cross-organizational, multi-stakeholder projects with a successful track record of delivery required.


• Demonstrated ability to work independently and collaboratively with multi-disciplinary teams with minimal oversight and direction from the manager required.


• Experience in pharmacy benefit implementation for Medicare, Medicaid or Commercial/Exchange membership is preferred.


• General familiarity with regulatory processes and guidelines governing health insurance products preferred.

Additional Information

• About Company: At Blue Shield of California we are parents, leader, students, visionaries, heroes, and providers. Everyday we come together striving to fulfill our mission, to ensure all Californians have access to high-quality health care at a sustainably affordable price. For more than 80 years, Blue Shield of California has been dedicated to transforming health care by making it more accessible, cost-effective, and customer-centric. We are a not-for-profit, independent member of the Blue Cross Blue Shield Association with 6,800 employees, more than $20 billion in annual revenue and 4.3 million members. The company has contributed more than $500 million to Blue Shield of California Foundation since 2002 to have a positive impact on California communities. Blue Shield of California is headquartered in Oakland, California with 18 additional locations including Sacramento, Los Angeles, and San Diego. We're excited to share Blue Shield of California has received awards and recognition for - LGBT diversity, quality improvement, most influential women in corporate America, Bay Area's top companies in volunteering & giving, and one of the world's most ethical companies. Here at Blue Shield of California, we're striving to make a positive change across our industry and the communities we live in - Join us!










• Physical Requirements: Office Environment - roles involving part to full time schedule in Office Environment. 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.
















• EEO Footer: 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.











• Requisition ID: 21001NZ













• Posting Date: May 7, 2021











• Schedule: Full-time

Apply Now