Pharmacist Business Segment Director - Medicaid

About Blue Cross and Blue Shield of Minnesota

At Blue Cross and Blue Shield of Minnesota, we are committed to paving the way for everyone to achieve their healthiest life. We are looking for dedicated and motivated individuals who share our vision of transforming healthcare. As a Blue Cross associate, you are joining a culture that is built on values of succeeding together, finding a better way, and doing the right thing.

If you are ready to make a difference, join us.

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.

• 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.

• 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 Pharm
  
  D.
• 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.

• 5+ years of managed care experience strongly preferred.
• Masters degree preferred or post graduate training, advanced training, or clinical program…