Pharmacist Business Segment Director - Medicaid

How Is This Role Important to Our Work?

Blue Cross and Blue Shield of Minnesota is hiring a Pharmacist Business Segment Director - Medicaid in Eagan, MN. This position provides strategic direction on Medicaid growth strategies while partnering with the Pharmacy Department to deliver clinical and business expertise. Responsibilities include developing and executing clinically effective programs that manage drug costs, improve member and provider experiences, and support organizational objectives. The role coordinates clinical components of the pharmacy program, represents the department internally and externally, as well as serves as the primary point of contact for the pharmacy business segment in member and client-facing meetings. Additional duties include leading initiatives in disease and case management, drug management initiatives, specialty pharmacy, patient safety, and clinical outcomes, as well as collaborating with the pharmacy benefit manager (PBM) on program interventions. This position requires a clear and active Pharmacist license in the state of Minnesota, 5+ years of managed care experience, strong Medicaid business acumen, and deep knowledge of drugs and therapies under medical and pharmacy benefits.

A Day in the Life:

• Support the Senior Director of Pharmacy in representing the department on clinical pharmacy issues as needed throughout the organization.
• Represent pharmacy department and/or lead clinical pharmacy meetings internally and externally.
• Point of contact for pharmacy business segment and represent the segment internally and externally.
• Lead projects and program implementation related, but not limited to, disease and/or case management, drug management initiatives, specialty pharmacy, patient safety and clinical outcomes.
• Pharmacy lead providing strategy direction on Medicaid growth strategies.
• Actively engage with the PBM or vendor clinical team in the design and coordination of benefit or clinical program elements including formulary management and utilization management.
• Oversee formulary submission in regulated markets.
• Provide hands-on consultation to members, groups, and/or health plan staff regarding appropriate benefit design, clinical outcomes, and cost issues.
• May manage and provide direction/oversight for other Pharmacy department staff.
• Monitor and evaluate effectiveness of Clinical programs.
• The job description in not intended to be an exhaustive list of all functions and responsibilities of the position. Employees are held accountable for all functions of the job. Job duties and the % of time identified for any function are subject to change at any time.
• Work is performed in an office setting. In-state and out-of-state travel occasionally required. Required travel between Eagan campus building locations.

Required Skills and Experiences:

• Accepting this director level position at BCBSMN requires signing an Employee Confidentiality, Intellectual Property Assignment and Restrictive Covenants Agreement as a condition of employment.
• Clear and active Pharmacist license in the state of Minnesota.
• BS degree in Pharmacy or PharmD.
• 5+ years of related professional experience. All relevant experience including work, education, transferable skills, and military experience will be considered.
• Excellent verbal and written communication skills.
• Superior analytical, quantitative, and problem solving skills.
• Strong business acumen.
• Proficient and confident conducting discussions in front of large and small groups.
• Can manage/lead one or several direct reports.

Nice to Have:

• 5+ years of managed care experience strongly preferred.
• Masters degree preferred or post graduate training, advanced training, or clinical program completion.
• Demonstrated hands-on Medicaid expertise, including direct experience with Medicaid benefits, formulary management, utilization management, and successful implementation of programs or initiatives within the Medicaid business.5+ years of managed care experience.
• Medicaid formulary experience.
• Proven decision-making experience, demonstrating the ability to evaluate complex information, make sound judgments, and take ownership of outcomes in a managed care or pharmacy benefits environment.

Compensation and Benefits:

Pay Range: $132,300.00 - $178,600.00 - $224,900.00 Annual

Pay is based on several factors which vary based on position, including skills, ability, and knowledge the selected individual is bringing to the specific job.

We offer a comprehensive benefits package which may include:

• Medical, dental, and vision insurance
• Life insurance
• 401k
• Paid Time Off (PTO)
• Volunteer Paid Time Off (VPTO)
• And more

To discover more about what we have to offer, please review our benefits page.

Role Designation

Hybrid

Anchored in Connection

Our hybrid approach is designed to balance flexibility with meaningful in-person connection and collaboration. We come together in the office two days each week - most teams designate at least one anchor day to ensure team interaction. These in-person moments foster relationships, creativity, and alignment. The rest of the week you are empowered to work remote.