Manager, Clinical and Specialty Pharmacy Programs

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POST DATE 9/15/2016
END DATE 1/26/2017

Blue Cross and Blue Shield of North Carolina Durham, NC

Durham, NC
AJE Ref #
Job Classification
Full Time
Job Type
Company Ref #
Mid-Career (2 - 15 years)
Bachelors Degree



With the assistance of senior pharmacy leadership, provides direction and ongoing coordination of clinical and specialty pharmacy program staff and related activities including new initiatives, major ongoing projects, program maintenance and development, and other ongoing business deliverables in accordance with business needs. Responsible for management and administration of formularies and pharmacy policies. Responsible for oversight of specialty pharmacy programs and specialty pharmacy network. Assists the department day to day management of corporate wide goals and identifies and mitigates risks or barriers to departmental goals. Works cross functionally with benefit operations and PBM (pharmacy benefit manager) to manage pharmacy programs.

* Provides oversight to departmental staff and multi-disciplinary project teams in the design, development and implementation of clinical pharmacy programs that support the prescription drug and medical benefit.

* Assist in the development of specialty pharmacy initiatives to manage trend targets and reduce medical expense. Provides oversight and performance management of the specialty pharmacy network. Oversees contract amendment process with existing pharmacies.

* Assists and manages the implementation, ongoing maintenances of pharmacy utilization management programs and policies for all Plan lines of business in order to manage to trend targets.

* Manages the development of and monthly maintenance of cost-effective formularies for the commercial benefit.

* Oversees the development and monthly maintenance of formularies for the Part D benefit

* Assists in the implementation and operational oversight of strategies to produce favorable medical expense and administrative pricing trends.

* Manage the staff of the clinical pharmacy and specialty pharmacy program department. This includes performance management, coaching, conflict resolution and motivating and engaging. Manage growth and development of personnel, with career development, performance management and succession planning.

* Identifies new clinical initiatives and modifications to current programs and processes to improve the company s competitive position.

* Manages and supports analysis of PBM clinical programs including rebate programs for the pharmacy and medical benefit.

* Responsible for the oversight and management of Pharmacy and Therapeutics Committee

* Provides ongoing analysis to determine program effectiveness and future development in conjunction with various Healthcare as well as other departments within the organization.

* Ensures all clinical pharmacy programs are compliant in accordance with regulations of State, Federal, and other accrediting bodies.

* Directs, manages, and/or supports implementation of corporate projects that impact clinical aspects of pharmacy services and its vendors.


* A Doctor of Pharmacy degree and 6 years pharmacy experience of which 4 years should be managed care pharmacy experience in the health care industry.

* Or an undergraduate degree in Pharmacy and 8 years of pharmacy experience of which 6 years should be managed care pharmacy experience in the health care industry.

* At least 3 years of experience managing people or managing several projects or programs simultaneously.

* The incumbent must be a licensed pharmacist in North Carolina or eligible for licensure in North Carolina.


* Extensive knowledge of state of the art managed care pharmacy programs and a proven clinical track record of developing cost-effective, high quality programs will be given priority.

* Prior drug utilization, (DUR) experience, ambulatory clinical pharmacy experience and drug formulary experience are desired.

* Proficient with standard PC skills (e.g. MS Word, Excel, MS Project and PowerPoint).

* Time management skills to keep goals and objectives on schedule.

* The ability to successfully interface with individuals at all levels within the organization, including top management, as well as with external parties is essential.

* The ability to determine the information necessary to strategically assess market situations as well as the ability to evaluate and determine optimal plans of action is essential.

* Excellent planning, interpersonal, problem solving, leadership and oral and written communication skills are required.

* Excellent influencing and consultative skills; and the ability to proactively identify and resolve issues and opportunities..