Pharmacy Benefit Management (PBM) teams with pharmacies, pharmaceutical manufacturers and physicians to manage the rising costs of prescription drug benefits and costs for our customers.
The Clinical Manager works collaboratively with Prime Therapeutics, Inc. or other third party Pharmacy Benefit Management companies to create and support the implementation of formulary and utilization management programs and management strategies; enhance pharmacy services; streamline processes; reduce administrative costs; improve operational activities; and ensure support and compliance with all government-related business. The incumbent also liaisons with BCBSAL internal divisions that are impacted by pharmacy benefit management projects. Examples include but are not limited to Marketing, CMS Operations, Consumer Products, Medical Policy/Review, Health, Claims, and Customer Service. Additional responsibilities include member and provider communication projects pertaining to communication of any pharmacy process changes, new program implementations, etc.
Summary of Qualifications
•Bachelor of Pharmacy or Doctor of Pharmacy degree
•Licensed in the state of Alabama
•Knowledge of the pharmaceutical industry, pharmacy benefits and current clinical pharmacy information
•Experience with formulary and utilization program development, submissions, and updates for Commercial and Medicare Part D pharmacy programs
•Experience leading projects to improve workflow/productivity
•Demonstrated ability to understand and analyze complex issues, problems and opportunities and make recommendations for solutions
•Ability to interpret and ensure compliance with applicable state and federal regulations
•Experience presenting information in formal and informal settings
•Excellent oral and written communication skills
•Excellent organizational skills and the ability to manage multiple projects
•Demonstrated use of effective interpersonal skills in interacting with all levels of associates and managers
•Ability to negotiate and integrate conflict management skills
•Strong attention to detail
•Medicare Part D experience is strongly preferred
Terms and Agreements
By submitting a job application, I attest that all information to the best of my knowledge is true and accurate. Furthermore, I understand that any information provided by me throughout the job application process is subject to verification including, but not limited to work experience, education, assessment (test) and interviews.
Our Company provides equal employment opportunities to minorities, females, veterans, and disabled individuals, as well as other protected groups.
Blue Cross and Blue Shield of Alabama, an independent licensee of the Blue Cross and Blue Shield Association, is a trusted name in healthcare. Since 1936, we have had one goal: to provide the best healthcare coverage in a caring and ethical manner.
Blue Cross and Blue Shield of Alabama administers health and dental programs for over 3 million individuals throughout the state of Alabama and... around the country. These individuals represent over 28,000 companies, including many of the state's and country's largest corporations, and small businesses with as few as two employees.