Sr Clinical Pharmacist

Hybrid Flex - Durham

Full time

RQ0019217

Job Description

We are hiring for a Senior Clinical Pharmacist! This individual will serve as the strategic clinical pharmacy lead and primary pharmacy advisor for a large employer client. You will be responsible for developing, communicating, and executing pharmacy benefit strategies that optimize clinical outcomes, member experience, and total cost of care. You will also acts as the primary clinical liaison between Blue Cross NC and client stakeholders, providing leadership across formulary management, utilization management, clinical programs, rebate strategy, and pharmacy operations. Also, this individual will partner closely with internal pharmacy, medical, finance, analytics, operations, and account management teams to ensure successful delivery of pharmacy benefit solutions and achievement of client objectives.

What You'll Do

• Serve as the strategic clinical pharmacy lead and trusted advisor for a large employer client, providing consultation and recommendations on pharmacy benefit strategy and performance.

• Develop and communicate pharmacy benefit strategies related to formulary design, utilization management, specialty pharmacy, clinical programs, and emerging drug trends.

• Collaborate with client leadership and internal stakeholders to align pharmacy strategies with business objectives, affordability goals, and member health outcomes.

• Lead and support client-facing meetings, quarterly business reviews, strategic planning sessions, and executive presentations.

• Evaluate pharmacy trend drivers, utilization patterns, pipeline therapies, and market developments to identify opportunities for program optimization.

• Provide clinical leadership and oversight for formulary management initiatives, utilization management programs, and evidence-based coverage strategies.

• Partner with rebate and financial teams to evaluate manufacturer contracting opportunities and rebate strategies that support client objectives.

• Support the development, implementation, and monitoring of clinical programs including specialty pharmacy management, site-of-care optimization, preventive medication strategies, and drug utilization initiatives.

• Collaborate with pharmacy operations teams to ensure successful implementation and ongoing management of pharmacy benefit programs.

• Analyze and present clinical and financial performance metrics, identifying emerging risks, opportunities, and recommended actions.

• Ensure compliance with applicable regulatory, accreditation, and quality requirements related to pharmacy benefits.

• Serve as a subject matter expert for internal business partners, sales teams, account management teams, and executive leadership.

• Maintain awareness of industry trends, emerging therapies, regulatory developments, and innovative pharmacy benefit solutions.

What You Bring

• Doctor of Pharmacy (PharmD) degree

• In lieu of degree, 10+ years of experience in related field.

• Active pharmacist license in North Carolina or ability to obtain licensure prior to hire.

Bonus Points(Preferred Qualifications)

• 5+ years of managed care, health plan, PBM, or employer pharmacy consulting experience.

• Experience serving as a dedicated clinical lead for a large employer, government, or public-sector client.

• Proven experience leading complex pharmacy initiatives involving multiple stakeholders and cross-functional teams.

• ⁠Demonstrated experience presenting and consulting with executive-level clients and external stakeholders.

• Strong experience with formulary management, utilization management strategy, pharmacy trend management, and clinical program development.

• Experience with rebate strategy, manufacturer contracting concepts, and pharmacy financial management preferred.

• Working knowledge of pharmacy operations, specialty pharmacy, and pharmacy benefit administration preferred.

• Excellent communication, relationship management, presentation, and influencing skills.

• Strong preference for candidates residing in or willing to relocate to the Raleigh-Durham area to support ongoing client engagement and partnership activities.

What You’ll Get

• The opportunity to work at the cutting edge of health care delivery with a team that’s deeply invested in the community

• Work-life balance, flexibility, and the autonomy to do great work

• Medical, dental, and vision coverage along with numerous health and wellness programs

• Parental leave and support plus adoption and surrogacy assistance

• Career development programs and tuition reimbursement for continued education

• 401k match including an annual company contribution

• Learn more (https://careers.bluecrossnc.com/global/en/benefits)

Salary Range

At Blue Cross NC, we take great pride in a fair and equitable compensation package that reflects market-price and our starting salaries are typically planned near the middle of the range listed. Compensation decisions are driven by factors including experience and training, specialized skill sets, licensure and certifications and other business and organizational needs. Our base salary is part of a robust Total Rewards package that includes an Annual Incentive Bonus*, 401(k) with employer match, Paid Time Off (PTO), and competitive health benefits and wellness programs.

*Based on annual corporate goal achievement and individual performance.

$118,691.00 - $189,906.00

Skills

Clinical Knowledge, Clinical Pharmacy, Clinical Practice Management, Clinical Programs, Clinical Review, Clinical Trials Operations, Medicare, Medicare Part D, Medication Therapy Management, Nursing Practice, Patient Care Coordination, Pharmaceutical Medical Affairs, Pharmacy, Pharmacy Compliance, Pharmacy Management, Pharmacy Operations

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About Us

It's an exciting time to work at Blue Cross and Blue Shield of North Carolina (Blue Cross NC). Health care is changing, and we're leading the way. We offer more than health insurance our customers can count on. We’re committed to better health and better health care − in our communities and beyond. Our employees bring energy and creativity to the workplace, and it shows in our innovative approach to improving the health and well-being of North Carolinians.

Blue Cross NC is a fully taxed, not-for-profit company headquartered in Durham, North Carolina. We serve more than 4.3 million members, and we employ more than 5,000 people across the country who are passionate about making health care better for all.

Help us lead the charge for better health care by joining our award-winning team. Discover tremendous opportunities with us to do challenging and rewarding work. Opportunities that can lead you to a fulfilling career, work that can help others lead healthier, happier lives.

Authorization to Work in the United States

We use E-verify to confirm authorization to work in the United States. To learn more about E-Verify, including your rights and responsibilities, please visit E-Verify Overview (https://www.e-verify.gov/employees/e-verify-overview) for English or Visión General de E-Verify (https://www.e-verify.gov/es/empleados/vision-general-de-e-verify) for Español.

Request Accommodations

Blue Cross NC provides reasonable accommodations to applicants with disabilities. If you need a reasonable accommodation for any part of the application or hiring process, please notify HR at [email protected] .

Blue Cross NC is a Hybrid Flex company. Whether the role is Hybrid Flex or Remote Flex depends on the nature of the work and distance from our Durham headquarters. We welcome candidates from outside the local area and in any of our approved states:

Alabama, Arizona, Arkansas, Colorado, Florida, Georgia, Idaho, Indiana, Iowa, Kansas, Kentucky, Louisiana, Maryland, Michigan, Mississippi, Missouri, North Carolina, Ohio, Oklahoma, Pennsylvania, South Carolina, South Dakota, Tennessee, Texas, Utah, Virginia, Wisconsin, and Wyoming