Program Manager, Consultant- Pharmacy Benefits Management

Blue Cross and Blue Shield Association

Oakland, CA

JOB DETAILS
SKILLS
Adjudication, Analysis Skills, Business Case, Communication Skills, Compensation and Benefits, Consulting, Cross-Functional, Health Plan, Identify Issues, Interpersonal Skills, Leadership, Microsoft Excel, Microsoft Office, Microsoft PowerPoint, Microsoft SharePoint, Operations Management, Options Analysis, Pharmacy, Presentation/Verbal Skills, Problem Solving Skills, Project/Program Management, Reporting Skills, Requirements Management, Root Cause Analysis, Strategic Planning, Team Player, Time Management, Writing Skills
LOCATION
Oakland, CA
POSTED
30+ days ago

Your Role

The Pharmacy Operations and Stabilization team provides management and end-to-end oversight of all Pharmacy operations, production stabilization issues, and drives issues from identification to resolution within a matrixed environment. The Program Manager, Consultant will report to the Sr Manager, Pharmacy Operations and Stabilization. In this role you will assure timely and accurate operations for your assigned areas, lead intake and initial assessment of new pharmacy issues, partner with subject matter experts to perform root cause analysis, identify impacts and potential solution options, develop and drive the summary and action plan including any remediation needed for medium to large issues impacting Pharmacy Strategy and Operations. Working in a matrixed environment, the Program Manager, Consultant will partner with cross-functional teams and external vendor partners to ensure alignment with stakeholders.

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

Your Knowledge and Experience

  • Requires a Bachelors degree or equivalent experience

  • 7 years of prior relevant experience required

  • Advanced knowledge of pharmacy operations at the health plan level including benefit build and adjudication and/or claims/financial data exchange

  • Excellent analytical and problem-solving skills

  • Excellent interpersonal, verbal and written communication skills that exhibit a solutions-oriented approach

  • Demonstrated leadership, project management, and executive level reporting experience

  • Experience using MS Office tools including Excel, PowerPoint, SharePoint and Project

Hybrid

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.

Your Work

In this role, you will:

  • Assure consistent, accurate, timely and compliance execution of assigned operational functions

  • Provide subject matter expertise and management of assigned operational functions

  • Provide overall program leadership, guidance, and manage all aspects of a given program, including requirements gathering, business case creation, and implementation

  • Develop resourcing strategies to ensure optimum support for projects and for the day-to-day operational activities

  • Lead cross-functional meetings and foster teamwork; drive escalation and resolution of issues, while promoting collaboration and coordination across broad categories of stakeholders

  • Lead intake efforts and perform initial assessment of new medium to large pharmacy production stabilization issues

  • Own, manage, and oversee the end-to-end activities associated with resolving the medium to large pharmacy production stabilization issues assigned to you

  • Develop a summary and action plan including root cause analysis, solution options, remediation efforts, and a timeline for resolution of each pharmacy issue

  • Develop and drive a resolution plan for highly matrixed and complex pharmacy production stabilization issues

  • Develop and distribute executive summary reports to keep key stakeholders informed of status and progress

  • Other duties as assigned

Your Work

In this role, you will:

  • Assure consistent, accurate, timely and compliance execution of assigned operational functions

  • Provide subject matter expertise and management of assigned operational functions

  • Provide overall program leadership, guidance, and manage all aspects of a given program, including requirements gathering, business case creation, and implementation

  • Develop resourcing strategies to ensure optimum support for projects and for the day-to-day operational activities

  • Lead cross-functional meetings and foster teamwork; drive escalation and resolution of issues, while promoting collaboration and coordination across broad categories of stakeholders

  • Lead intake efforts and perform initial assessment of new medium to large pharmacy production stabilization issues

  • Own, manage, and oversee the end-to-end activities associated with resolving the medium to large pharmacy production stabilization issues assigned to you

  • Develop a summary and action plan including root cause analysis, solution options, remediation efforts, and a timeline for resolution of each pharmacy issue

  • Develop and drive a resolution plan for highly matrixed and complex pharmacy production stabilization issues

  • Develop and distribute executive summary reports to keep key stakeholders informed of status and progress

  • Other duties as assigned

About the Company

B

Blue Cross and Blue Shield Association

At the Blue Cross and Blue Shield Association (BCBSA), we provide business strategy, technical support and consulting expertise to 36 Blue Cross and Blue Shield companies across the nation, employing more than 1,000 of the best strategic thinkers in the industry. We are a Brand manager that sets quality control standards for the 36 independent companies that use the Blue Cross and Blue Shield Brands, and we serve as a trade association that represents these Blue companies. It is through our involvement that the Blues companies share a united vision and strategy while also benefiting from the local strength of all member companies.
COMPANY SIZE
2,000 to 2,499 employees
INDUSTRY
Insurance
WEBSITE
https://www.bcbs.com/about-us/careers