Full-time Director, Pharmacy Strategy and Performance, Blue Shield of California

01Your Role

• The Blue Shield of California (BSC) Pharmacy team comprises of over 350
• dedicated professionals who are passionate about making a meaningful impact by

reimagining pharmacy care. Ensuring every member has safe, equitable access to

sustainably affordable pharmacy benefits is at the heart of everything we do.

The Director, Pharmacist - Strategy and Performance will report to the Vice

President, Pharmacy Performance at BSC.  In this role, you will lead a team

responsible for developing and executing enterprise pharmacy strategy across the

pharmacy and medical benefits. You will oversee drug and network contracting,

contract performance, and financial performance across provider-administered

drugs, home infusion, and retail and specialty pharmacy networks. Additionally,

you will partner closely with Pharmacy Clinical Leadership, Medical Management,

Finance, Actuary, Provider Contracting, and external pharmacy benefit management

(PBM) partners to identify and implement strategies that improve drug trend

management and maximize value for members, clients, and the organization.

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.

02RESPONSIBILITIES

Your Work

In this role, you will:

• Lead development and execution of pharmacy affordability and value-based
• strategies across both pharmacy and medical drug spend understanding industry
• trends, market dynamics, regulatory changes, and competitive landscape
• Evaluate industry trends, market dynamics, and competitive landscape to help
• inform strategic decisions
• Own enterprise drug contracting strategy across the pharmacy and medical
• benefits, including manufacturer agreements, rebate contracting, value-based
• and outcomes-based arrangements, financial guarantees, and related contract
• performance
• Lead contracting and affordability strategies for drugs covered under the
• medical benefit, including provider-administered drugs and specialty
• therapies, in partnership with Provider Contracting and Network Management
• Design and implement reimbursement and site-of-care strategies that promote
• delivery in clinically appropriate, cost-effective settings
• Establish strategic direction, contracting requirements, and performance
• oversight for pharmacy and medical benefit networks, including retail,
• specialty pharmacy, home infusion, mail order, ancillary pharmacy, and
• provider networks supporting provider-administered drugs
• Monitor financial, operational, access, and quality performance through key
• performance indicators and contractual guarantees and evaluate emerging
• network designs and alternative drug distribution models
• Develop business cases and financial models supporting pharmacy strategic
• initiatives monitoring pharmacy trend, rebate performance, medical drug
• spend, and network economics
• Utilize data analytics to evaluate utilization patterns, identify savings
• opportunities, and measure program effectiveness
• Present performance results and strategic recommendations to senior
• leadership and executive stakeholders
• Build strong partnerships with internal stakeholders, PBM leadership,
• providers, pharmaceutical manufacturers, and industry organizations

03QUALIFICATIONS

Your Knowledge and Experience

• Requires a currently active and unrestricted California Registered Pharmacist
• (RPh) license
• Requires a Doctor of Pharmacy (PharmD) degree from an accredited school of
• pharmacy in the U.S.
• Requires 10 years of prior relevant experience in a managed care health plan
• or pharmacy benefit management company or other relevant settings
• Requires 6 years of prior people management experience with direct
• responsibility for supervising, coaching, and evaluating direct reports
• Requires excellent communication skills with prior experience in
• presentations to internal and external executive level business stakeholders
• Knowledge of pharmacy benefits, formulary, network programs for drugs covered
• in pharmacy and medical benefits
• Prior experience in vendor partnership, contract operations, negotiations,
• and performance management is preferred
• Strong business acumen with proven experience in pharmacy strategy
• development and planning
• Excellent presentation, verbal and written skills with ability to understand
• and convey complex ideas to audience with diverse backgrounds
• Detail-oriented with the ability to work in a fast-paced environment
• Exhibit a "can do" attitude and solution-oriented approach to resolve
• challenges

04Hybrid

• This role requires employees to be in-office based on our hybrid workplace

model, balancing purposeful in-person collaboration with flexibility. For most

teams, this means coming into the office two days each week.

Employees living more than 50 miles from an office location will work with their

manager to determine in-office time based on business need.

05About Blue Shield of California

• As of January 2025, Blue Shield of California became a subsidiary of Ascendiun.
• Ascendiun is a nonprofit corporate entity that is the parent to a family of
• organizations including Blue Shield of California and its subsidiary, Blue
• Shield of California Promise Health Plan; Altais, a clinical services company;

and Stellarus, a company designed to scale healthcare solutions. Together, these

organizations are referred to as the Ascendiun Family of Companies.

At Blue Shield of California, our mission is to create a healthcare system

worthy of our family and friends and sustainably affordable. 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 achieve our mission, we foster an environment where all employees can thrive

and contribute fully to address the needs of the various communities we serve.

We are committed to creating and maintaining a supportive workplace that upholds

our values and advances our goals.

Blue Shield is a U.S. News Best Company to work for, a Deloitte U.S. Best

Managed Company and a Top 100 Inspiring Workplace. We were recognized by Fair360

as a Top Regional Company, and one of the 50 most community-minded companies in

the United States by Points of Light. 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 listen and communicate effectively, showing empathy by
• understanding others' perspectives.
• Courageous. We stand up for what we believe in and are committed to the hard
• work necessary to achieve our ambitious goals.

06Our Workplace Model

• We believe in fostering a workplace environment that balances purposeful
• in-person collaboration with flexibility - providing clear expectations while

respecting the diverse needs of our workforce. Our workplace model is designed

07around intentional in-person interaction, collaboration,

• connection, creativity and flexibility:
• For most teams, this means coming into the office two days per week.
• Employees living more than 50 miles from an office location, out of state
• employees, and employees in certain member-facing roles should work with
• their manager to determine in-office time based on business need.
• For employees with medical conditions that may impact their ability to work
• in-office, we are committed to engaging in an interactive process and
• providing reasonable accommodations to ensure their work environment is
• conducive to their success and well-being.
• The Company reserves the right to require more presence in the office based on
• business needs, and requirements are subject to change with periodic reviews.
• 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.

08[https://www.blueshieldca.com/physical-job-requirements]

• 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.