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President, Specialty Pharmacy; Newco

Company: 
BCBSA
CIty: 
Chicago
State: 
Illinois
Occupational fields: 
Management
Employment type: 
Full time
Remote Position: 
No
Required degree level: 
Other

Overview

The President of Specialty Pharmacy will lead this new entity (Newco) and be a direct report to the CEO of BCBSA, driving the implementation of the BCBS System's specialty pharmacy strategy. The President's focus will be to create and ensure alignment across the BCBS System in medical benefit specialty pharmacy, driving affordability and capturing value from the current spend across the Blues today. The initial focus of the strategy will be Cell & Gene Therapies (CGT) which are projected to grow at a rapid pace through 2026.

The implementation of this strategy will be incubated within BCBSA for 12-24 months before re-evaluating future ownership and funding. The President will be responsible for standing up Newco in the near-term (e.g., build team, identify and deploy technology requirements, lead the development of both value- and volume-based contracts, develop real-world evidence tracking while architecting the evolution of the BCBS System's specialty pharmacy strategy.

Responsibilities

Responsibilities include but are not limited to:

  • Build a team of experts to drive implementation, supplementing existing, limited staff
  • Oversee the execution of the National Pharmacy & Therapeutics (P&T) and the Value Assessment Committees (VAC)
    • The P&T is made up of third-party independent clinical experts that evaluate safety and efficacy of medical benefit drug classes and provide clinical input and recommendations on coverage and medical policy options
    • The VAC is made up of BCBS Plan Executives with decision-making authority that evaluate P&T clinical recommendations with an economic and business assessment, making final decisions on preferred drug lists and medical policies for Plan adoption
  • Lead the team in negotiations with pharmaceutical manufacturers to develop innovative, market-leading outcomes-based arrangements for CGT and pipeline therapies
  • Determine best-in-breed approach to executing volume-based contracts with pharmaceutical manufacturers, vetting opportunities to partner with existing Blue assets
  • Lead the team in developing a real-world evidence platform to drive ongoing analytics and insights around drug efficacy and member outcomes; and use to inform ongoing contract negotiations with manufacturers
  • Develop innovative approaches to optimize BCBS national network design and steer to lower-cost sites of care for provider-administered drugs across the BCBS System
  • Ongoing engagement with BCBS Plan executives and BCBSA Board-34 BCBS Plan CEOs-to facilitate engagement, alignment, and adoption of Newco's capabilities and offerings
  • Develop and execute innovative approaches to value- and volume-based contracting in the medical benefit specialty pharmacy space near- and long-term



Qualifications

Required Basic Qualifications:

  • Bachelor's degree in business administration, or a related healthcare discipline, or equivalent experience.
  • 15 years' experience in leading a pharmacy-focused company or pharmacy business within a large organization; ideal candidate will have experience with medical benefit specialty pharmacy
  • Previous trade or manufacturer contracting responsibilities within a PBM with focus on medical benefit
  • Experience developing innovative solutions to drive efficiency and quality in the pharmacy space
  • Five years of senior management experience with demonstrated knowledge of strategic planning and experience developing and implementing strategies for achieving business objectives and organizing and managing multiple priorities.
  • Ten years of senior management experience
  • Excellent oral and written communication skills with the capabilities to negotiate, persuade, and make effective presentations to varying audiences internal and external to BCBSA
  • A high level of confidence, integrity, can-do attitude, and critical thinking skills are required, as well as a professional executive presence for interacting with and influencing key leadership and decision-makers within the BCBS system, as well as with external stakeholders
  • Excellent interpersonal skills for building and fostering key relationships
  • The ability to establish credibility and be decisive and results oriented while balancing varying business considerations/priorities is critical, as well as is the ability to demonstrate good judgment and critical thinking relative to problem analysis/resolution at both the strategic and functional levels
  • Must have demonstrated leadership skills relative to staff management and achieving results through others
  • Exceptional project management capabilities for the effective deployment of resources and achievement of multiple projects in a cross-functional environment


Preferred Basic Qualifications:

  • Master's degree
  • Understanding of the BCBS System; strong relationships with BCBS Plan CEOs preferred



Equal Opportunity Employer

Blue Cross Blue Shield Association is an equal opportunity employer. We evaluate qualified applicants without regard to race, color, religion, sex, sexual orientation, national origin, age, gender identity, disability, veteran status, genetic information or any other legally protected characteristics.

Make an impact on healthcare in America. A career with Blue Cross Blue Shield Association allows you to be part of the foundation that supports the 35 Blue Cross and Blue Shield companies nationwide, while protecting and strengthening the Blue Cross Blue Shield brand. Our work is helping provide greater access to cost-effective healthcare, improve the health of America and build stronger communities. With a commitment to diversity, equity and inclusion, we celebrate different cultures, languages, backgrounds and experiences while striving to advance health equity, and we want you to join Team BCBSA.

Accommodations:
Vision Accommodations, Hearing Accommodations, Neurodiversity, Learning, Mental Health, Mobility