Sr. Strategic Advisor, Medicare Pharmacy

Additional Locations:Job DescriptionThis role will report to the Director, Strategy and Growth in Corporate Pharmacy and will lead strategic initiatives for the Medicare pharmacy program. The Sr. Strategic Advisor, Medicare Pharmacy will leverage industry experience and expertise to oversee strategy and execution of Medicare Advantage, DSNP, and PDP goals for Quality, Cost of Care and Product. This position will work cross-functionally with teams from Government Pharmacy, Corporate Pharmacy Cost of Care, and Medicare Actuarial Pricing. The ideal candidate will have experience with the Medicare Prescription Drug Program, pharmacy program management, possess project management skills, and understand revenue strategy and quality programs within Medicare Advantage and Part D.

• Proactively identify, evaluate and lead the development of strategic initiatives for the Medicare pharmacy program. Effectively collaborate with internal stakeholders, our Pharmacy Benefit Manager (PBM), and key vendors to meet BCBSNC's affordability and quality objectives specific to Medicare Advantage and PDP.

• Lead and manage development efforts related to the enhancement and maintenance of our current Medicare pharmacy products and market offer components.

• Lead and coordinate the development of products and partnerships in response to CMS regulations and/or to meet pharmacy product goals that are aligned with Enterprise stakeholders.

• Lead and coordinate the development of operations, products and partnerships to meet pharmacy quality goals that are aligned with Enterprise stakeholders.

• Lead and coordinate the ideation and development of initiatives to meet pharmacy Cost of Care goals.

• Lead and coordinate strategic planning for the Government vertical of Corporate Pharmacy.

• Present information such as strategic concepts, planning and outcomes data to both internal and external audiences at all levels, including senior-level leadership.

• Organize, optimize and communicate progress towards the completion of optimal Medicare pharmacy product portfolio.

• Collaborate with and support other departments across the enterprise on both common initiatives and unique ventures, acting as a subject matter expert for corporate pharmacy, specific to Medicare.

• Identify, analyze and monitor industry, regulatory, technology and market-based trends that affect departmental Medicare strategy, PBM landscape, pharmacy trend, and cost of care.

• Plan, develop, implement and manage programs on a department level. Coordinate functions within and outside of the corporate pharmacy department in order to minimize delays; work with program/project team members on a regular basis to review deliverables and ensure deadlines are met.

• Facilitate and synthesize the development of a multi-year strategy and execution plan to achieve Medicare Pharmacy Stars and Quality goals.

• Facilitate and synthesize insights related to Medicare Formulary and Network to inform Product design decisions.

Hiring Requirements

* Bachelor's degree or advanced degree (where required)

* 5+ years of experience in related field.

* In lieu of degree, 7+ years of experience in related field.

• Direct experience leading and implementing pharmacy programs. Medicare Prescription Drug Program specific experience required.

• Excellent communication and collaboration skills to work with various stakeholders, teams, sponsors, members, vendors, senior management, and providers and pharmacists.

• Experience related to the management and delivery of programs, projects and work efforts in a portfolio-based environment.

• The ideal candidate will have extensive experience with Medicare Advantage, DSNP, EGWP, and PDP and PBMs.