Job Details

Join Our Team: Do Meaningful Work and Improve People's Lives

Our purpose, to improve customers' lives by making healthcare work better, is far from ordinary. And so are our employees. Working at Premera means you have the opportunity to drive real change by transforming healthcare.

We are seeking a strategic Health Plan Pharmacy leader that will oversee pharmacy clinical operations, PBM relationship, formulary, utilization management, and other pharmacy programs and lead the implementation of pharmacy initiatives to ensure regulatory, affordability, clinical quality, and access objectives are achieved. This role provides people, program, and strategic leadership in close partnership with the VP and peer Director of Pharmacy & Clinical Consulting to drive business outcomes.

The Director, Pharmacy Operations & PBM Management will provide direction and oversight in Premera's Pharmacy strategy, anchored on continuous evolution and enhancement in our dynamic environment as market, customer and regulatory needs shift, clinical innovation and technology advances, and pharmacy value chain complexity increases.

In this role, your leadership will:

• Evolve our pharmacy management model, by building new TCOC (total cost of care) management capabilities and strategic relationships.
• Partner across the organization in the development and achievement of business goals, ensuring alignment with long-term strategic objectives.
• Develop others to champion Premera's purpose to serve our customer and make healthcare work better.

What you will do:

• Set strategic direction for program development, achieving appropriate outcomes and business performance measures related to access, affordability, quality, and experience, including business performance, clinical pharmacy operations, PBM and vendor oversight, utilization management, and formulary.
• Ensure operational excellence, overseeing key areas such as clinical pharmacy operations, PBM and vendor oversight, utilization management, formulary etc. Stay abreast of managed care pharmacy, pharmacy benefits manager, and payer industry environment; regulatory (e.g. state, federal), legislative, accreditation, and competitive market insights – for all lines of business (Commercial (WA, AK), Individual (WA, AK), HMO, FEP).
• Collaborate on the development and implementation of comprehensive strategies for drugs across both pharmacy and medical benefits (including specialty, biosimilar, cell and gene therapies).
• Partner across the organization in the formulary strategy, clinical programs, product, benefit design, and vendor negotiations.
• Participate and lead cross-functional projects with multiple internal and external stakeholders and partners.
• Develop effective relationships with functional areas across the organization, driving thoughtful, integrated health plan business outcomes.
• Lead multidisciplinary teams in core areas of responsibility providing individuals growth opportunities to meet the evolving needs of the business.

Premera total rewards

Our comprehensive total rewards package provides support, resources, and opportunities to help employees thrive and grow. Our total rewards are more than a collection of perks, they're a reflection of our commitment to your health and well-being. We offer a broad array of rewards including physical, financial, emotional, and community benefits, including:

• Medical, vision, and dental coverage with low employee premiums.
• Voluntary benefit offerings, including pet insurance for paw parents.
• Life and disability insurance.
• Retirement programs, including a 401K employer match and, believe it or not, a pension plan that is vested after 3 years of service.
• Wellness incentives with a wide range of mental well-being resources for you and your dependents, including counseling services, stress management programs, and mindfulness programs, just to name a few.
• Generous paid time off to reenergize.
• Looking for continuing education? We have tuition assistance for both undergraduate and graduate degrees.
• Employee recognition program to celebrate anniversaries, team accomplishments, and more.

For our hybrid employees, our on-campus model provides flexibility to create your own routine with access to on-site resources, networking opportunities, and team engagement.

• Commuter perks make your trip to work less impactful on the environment and your wallet.
• Free convenient on-site parking.
• Subsidized on-campus cafes make lunchtime connections with colleagues fun and affordable.
• Engaging on-site events and activities include food trucks, health and wellness, DEI and disaster preparedness fairs, coffee connects, and more.
• Our complementary fitness & well-being center offers both in-person and virtual workouts and nutritional counseling.
• Need a brain break? Challenge someone to a game of shuffleboard or ping pong while on campus.

Equal employment opportunity/affirmative action:

Premera is an equal opportunity/affirmative action employer. Premera seeks to attract and retain the most qualified individuals without regard to race, color, religion, sex, national origin, age, disability, marital status, veteran status, gender or gender identity, sexual orientation, genetic information or any other protected characteristic under applicable law.

If you need an accommodation to apply online for positions at Premera, please contact Premera Human Resources via email at ...@premera.com or via phone at 425-###-####.

The pay for this role will vary based on a range of factors including, but not limited to, a candidate's geographic location, market conditions, and specific skills and experience.

Salary Range:

$153,700.00 - $307,400.00

We're happy to discuss compensation further during the interview because we believe that open communication leads to better outcomes for all. We're committed to creating a diverse and inclusive environment where all employees are celebrated for their unique skills and contributions.

About Us

At Premera, we make healthcare work better. By focusing on improving our customers' experience purposefully and serving their needs passionately, we make the process easier, less costly, and more positive. Through empathy and advocacy, we change lives.

As the leading health plan in the Pacific Northwest, we provide comprehensive health benefits and services to more than 2 million customers, from individuals to Fortune 100 companies. Our services include innovative programs focused on health management, wellness, prevention, and patient safety. We deliver these programs through health, life, vision, dental, disability, and other related products and services.

Premera Blue Cross is headquartered in Mountlake Terrace, WA, with operations in Spokane and Anchorage. The company has operated in Washington since 1933 and in Alaska since 1952. With more than 80 years of experience in the region, we deliver innovation, choice, and expertise.