AVP, Chief Pharmacy Officer

AVP, Chief Pharmacy Officer

Why should you join the BlueCross BlueShield of South Carolina family of companies? Other companies come and go, but we've been part of the national landscape for more than seven decades, with our roots firmly embedded in the South Carolina community. We are the largest insurance company in South Carolina and much more. We are one of the nation's leading administrators of government contracts. We operate one of the most sophisticated data processing centers in the Southeast. We also have a diverse family of subsidiary companies, allowing us to build on various business strengths. We deliver outstanding service to our customers. If you are dedicated to the same philosophy, consider joining our team!

Position Purpose : As AVP, Chief Pharmacy Officer, you will be responsible for overseeing all BlueCross and BlueChoice private business commercial, exchange and Medicaid pharmacy formularies and related clinical program initiatives. You will lead and direct the development and execution of formulary and clinical strategies for delivering pharmacy services. In this role, the AVP, Chief Pharmacy Officer will foster strong relations with internal departments and external providers and serves as pharmacy subject matter expert on variety of commercial and government internal and external committees and workgroups.

Location : This position is full-time (40-hours / week) Monday-Friday with a HYBRID schedule (3 days in office / 2 days remote) at our 4101 Percival Road, Columbia, SC 29229 location.

What You'll Do :

• Directs, manages, and oversees all aspects of private business commercial, exchange and Medicaid pharmacy formulary and related clinical program initiatives.
• Leads and directs the development and execution of clinical management strategies for delivering pharmacy services.
• Develops pharmaceutical guidelines including but not limited to preferred drug lists, utilization management, formulary management, benefits management, and benefit designs.
• Directs pharmacy services rendered by PBMs, such as claims processing, PDL management, UM, and pharmacy trend.
• Oversees formulary management functions.
• Fosters strong relations with internal departments and external providers and serves as pharmacy subject matter on variety of commercial and government internal and external committees and workgroups.
• Provides pharmacy support and documentation for contracting determinations.
• Evaluates customer requests and individual line of business needs.
• Coordinates proposal and grants requests for new pharmacy offerings.
• Reviews and adjusts contract to exclude no value added drugs.
• Coordinates with provider contracting on the pricing / fee schedules, and evaluates the impact to the network.
• Works directly with legal department on contractual language.
• Anticipates and responds to the needs of the customer organization related to pharmacy programs and facilitates the successful implementation of the program and retention of the customer.
• Leads the development of policies and procedures to ensure compliance with all corporate and government regulations.
• Responsible for assessing external pharmacy industry trends and developments that represent risk and opportunities for the organization.
• Develops short and longterm plans to respond to potential risks and to capitalize on opportunities.
• Engages with senior leaders and key stakeholders to ensure the optimal utilization of technology and resources, to support the implementation of enterprise-wide pharmacy systems and processes.
• Directs the evaluation and refinement of the pharmacy program and related services provided by internal and external departments / entities.
• Ensures compliance with clinical goals of all pharmacy programs.
• Directs cost and benefits analysis for drugs, and evaluates the effectiveness of the programs and modifies programs as needed to achieve desired results in collaboration with pharmacy area leaders.
• Reviews prescribing guidelines and maintains expertise related to medications and best practices.
• Stays informed of additions and changes to medication options, release of generics, changes to prescribing guidelines and all other medical / clinical knowledge required.
• Contributes to the development of the clinical mission of pharmacy programs, including the development, implementation, and evaluation of clinical / medical aspects of pharmacy related initiatives.
• Monitors department performance and productivity.
• Manages budget to ensure cost effectiveness and performance quality.
• Assists marketing team with oversight of various materials and other required notifications.

To Qualify For This Position, You'll Need The Following :

We Prefer That You Have The Following :

Our Comprehensive Benefits Package Includes The Following :

What We Can Do for You :

We understand the value of a diverse and inclusive workplace and strive to be an employer where employees across all spectrums have the opportunity to develop their skills, advance their careers and contribute their unique abilities to the growth of our company.

What To Expect Next :

After submitting your application, our recruiting team members will review your resume to ensure you meet the qualifications. This may include a brief telephone interview or email communication with our recruiter to verify resume specifics and salary requirements.

Equal Employment Opportunity Statement

BlueCross BlueShield of South Carolina and our subsidiary companies maintain a continuing policy of nondiscrimination in employment to promote employment opportunities for persons regardless of age, race, color, national origin, sex, religion, veteran status, disability, weight, sexual orientation, gender identity, genetic information or any other legally protected status. Additionally, as a federal contractor, the company maintains affirmative action programs to promote employment opportunities for individuals with disabilities and protected veterans. It is our policy to provide equal opportunities in all phases of the employment process and to comply with applicable federal, state and local laws and regulations.

We are committed to working with and providing reasonable accommodations to individuals with disabilities, pregnant individuals, individuals with pregnancy-related conditions, and individuals needing accommodations for sincerely held religious beliefs, provided that those accommodations do not impose an undue hardship on the Company.

If you need special assistance or an accommodation while seeking employment, please email mycareer.help@bcbssc.com or call 800-288-2227, ext. 47480 with the nature of your request. We will make a determination regarding your request for reasonable accommodation on a case-by-case basis.

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