Program Manager, Principal

Program Manager, Principal

The Cost of Health Care (COHC) & Specialty Drug Management Pharmacy team is responsible for managing the Specialty Drug strategies across the pharmacy and medical benefit and leading and implementing cost of health care initiatives.

In this role you will be responsible for coordinating COHC operations, supporting cross-functional pharmacy affordability forums, and driving implementation of selected pharmacy initiatives that advance trend, savings, quality, and operational performance objectives. This role partners closely with pharmacy leadership, analytics, lines of business, product, actuarial, network, clinical, and COHC governance stakeholders to maintain a clear initiative roadmap, monitor program performance, and ensure timely execution of priority work.

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 and critical thinking, building and sustaining high-performing teams, getting results the right way, and fostering continuous learning.

Responsibilities

In this role, you will:

• Lead COHC operations support, including tracking of pharmacy affordability initiatives, coordination of initiative status updates, and follow-through on operational deliverables
• Coordinate COHC forums, including agenda development, stakeholder preparation, meeting facilitation support, action item tracking, and alignment with related governance and line-of-business forums
• Organize stakeholder deep dives on material trend drivers, emerging pharmacy opportunities, medical and pharmacy benefit drug initiatives, and priority affordability topics requiring cross-functional input
• Develop, maintain, and distribute COHC program performance reporting, including initiative performance, savings versus plan, trend drivers, biosimilar adoption, implementation milestones, risks, and executive-ready summaries
• Support implementation of key COHC pharmacy initiatives, including specialty drug management, biosimilar strategies, site-of-service opportunities, rebate and vendor strategies, and other roadmap priorities
• Maintain the pharmacy initiative roadmap and COHC program portfolio, ensuring initiatives are documented, prioritized, assigned to accountable owners, updated for status and milestones, and aligned to annual and multi-year financial targets

Qualifications

Your Knowledge and Experience:

• Requires a Bachelor's degree or High School Diploma/GED and 4 years of additional relevant experience in lieu of a degree. Master's Degree is preferred
• Requires 10 years of prior relevant experience in pharmacy program development and implementation of companywide initiatives, organization development, and process improvement programs
• Previous program management experience in multi-disciplinary settings
• Knowledge of Blue Shield of California or similar health care organization structure
• Strong business acumen with proven experience in thinking strategically
• Strong data analytic and data management skills with the ability to perform analysis using summarized and/or detail claims information
• Strong collaboration and partnership skills in a matrixed work environment
• Excellent verbal and written skills with the ability to understand complex ideas and convey proposition statements to clinical and non-clinical audiences
• Experience in driving cross functional meetings to drive resolution of issues and/or establish priorities and timelines for program implementations
• Proficiency in Microsoft Word, Power Point, and Excel
• Detail oriented skills with the ability to work in a fast-paced environment
• Ability to successfully work with other functional departments within a health plan
• Ability to work independently with minimum direction or supervision
• Ability to produce accurate and quality work under tight deadlines
• Ability to manage challenging situations in a positive and constructive manner
• Ability to exhibit a "can do" attitude and solution-oriented approach to resolve challenges
• Ability to be a team player and be flexible in work assignments to provide support of peers
• TQM, Six Sigma certification or Project Management certification is preferred

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.

About Us

About Blue Shield of California

As of January 2025, Blue Shield of California became a subsidiary of Ascendiun. Ascendiun is a nonprofit corporate entity that is the parent to a family of organizations including Blue Shield of California and its subsidiary, Blue Shield of California Promise Health Plan; Altais, a clinical services company; and Stellarus, a company designed to scale healthcare solutions. Together, these organizations are referred to as the Ascendiun Family of Companies.

At Blue Shield of California, our mission is to create a healthcare system worthy of our family and friends and sustainably affordable. We are transforming health care in a way that genuinely serves our nonprofit mission by lowering costs, improving quality, and enhancing the member and physician experience.

To achieve our mission, we foster an environment where all employees can thrive and contribute fully to address the needs of the various communities we serve. We are committed to creating and maintaining a supportive workplace that upholds our values and advances our goals.

Blue Shield is a U.S. News Best Company to work for, a Deloitte U.S. Best Managed Company and a Top 100 Inspiring Workplace. We were recognized by Fair360 as a Top Regional Company, and one of the 50 most community-minded companies in the United States by Points of Light. Here at Blue Shield, we strive to make a positive change across our industry and communities – join us!

Our Values:

• Honest. We hold ourselves to the highest ethical and integrity standards. We build trust by doing what we say we're going to do and by acknowledging and correcting where we fall short.
• Human. We strive to listen and communicate effectively, showing empathy by understanding others' perspectives.
• Courageous. We stand up for what we believe in and are committed to the hard work necessary to achieve our ambitious goals.

Our Workplace Model

We believe in fostering a workplace environment that balances purposeful in-person collaboration with flexibility - providing clear expectations while respecting the diverse needs of our workforce. Our workplace model is designed around intentional in-person interaction, collaboration, connection, creativity and flexibility:

• For most teams, this means coming into the office two days per week.
• Employees living more than 50 miles from an office location, out of state employees, and employees in certain member-facing roles should work with their manager to determine in-office time based on business need.
• For employees with medical conditions that may impact their ability to work in-office, we are committed to engaging in an interactive process and providing reasonable accommodations to ensure their work environment is conducive to their success and well-being.

The Company reserves the right to require more presence in the office based on business needs, and requirements are subject to change with periodic reviews.

Physical Requirements:

Office Environment - roles involving part to full time schedule in Office Environment. Based in our physical offices and work from home office/deskwork - Activity level: Sedentary, frequency most of work day.

Please click here for further physical requirement detail.

Equal Employment Opportunity:

External hires must pass a background check/drug screen. Qualified applicants with arrest records and/or conviction records will be considered for employment in a manner consistent with Federal, State and local laws, including but not limited to the San Francisco Fair Chance Ordinance. All qualified applicants will receive consideration for employment without regards to race, color, religion, sex, national origin, sexual orientation, gender identity, protected veteran status or disability status and any other classification protected by Federal, State and local laws.