Team Leader Pharmacy - Clinical Programs - job 1 of 2

Why Wellmark: We are a mutual insurance company owned by our policy holders across Iowa and South Dakota, and we’ve built our reputation on over 80 years’ worth of trust. We are not motivated by profits. We are motivated by the well-being of our friends, family, and neighbors–our members. If you’re passionate about joining an organization working hard to put its members first, to provide best-in-class service, and one that is committed to sustainability and innovation, consider applying today! 

Learn more about our unique benefit offerings here. 

*As Team Leader Pharmacy-Clinical Programs, you will be eligible to work remotely from your home location, with the expectation of travel to the Des Moines, Iowa office 2 weeks each month on average.  Candidates in the Central Time Zone and/or with a direct flight to Des Moines, Iowa are preferred. Candidates in the Des Moines metro will be in-office Tues-Thurs weekly.*

Use your strengths at Wellmark as a Team Leader of Pharmacy Clinical Programs!    

About the Opportunity: As a people leader, you will guide, mentor and lead a multi-functional team of Clinical Pharmacists supporting managed care work across the organization. You will lead and support team members through their development and success, while removing barriers that may arise for the team. In addition, you will be responsible for the day-to-day management and oversight of the development and maintenance of comprehensive clinical pharmacy programs in partnership with Wellmark’s Pharmacy & Therapeutics (P&T) Committee. In collaboration with Pharmacy leadership, you will be responsible for ensuring the implementation of strategic program goals in a highly matrixed environment. In addition, you will develop and monitor clinical operational approaches for the Clinical Pharmacy team, such as KPI development and metrics oversight. You will aid in clinical operations oversight of vendor management to ensure program deliverables are achieved. As a strategic leader, you will be responsible for managing, collaborating and communicating at all levels, ensuring essential information is disseminated to achieve objectives and goals.  

About You: As a leader of others, you will directly impact the success, growth, and development of team members by setting clear expectations, defining accountabilities, providing regular coaching, facilitating change, and providing an overall positive work environment. Being a role model in behaviors that demonstrate Wellmark’s Leader Success Expectations is a must. You are a strong change leader who demonstrates both flexibility and resiliency. You are at your best when you can strategically think both up and downstream, use data to inform decisions, and creatively solve problems – plus, you love to inspire and coach others to do the same.   

Required Qualifications:

• Bachelor's degree in Pharmacy OR PharmD.
• Licensure:  An active and unrestricted Pharmacy license in Iowa or South Dakota (individual must be licensed in the state in which they reside) is required within 6 months from date of hire.
• 5+ years of managed care pharmacy or pharmacy residency program experience, including demonstrated coaching/mentoring experience, and broad understanding of the health care delivery system, managed care and pharmacy benefit management systems, plan design and overall operations. Advanced knowledge of medical literature retrieval and evaluation.
• Leadership experience gained through a combination of project or informal leadership.
• Ability to measure, evaluate and/or improve work processes, programs, and services; ensures alignment with strategic goals.
• Self-starter able to produce quality results based off strong decision-making skills.
• Excellent analytical, problem solving, and critical thinking skills. Ability to independently make effective evidence-based decisions and coach/guide others.
• Outstanding written and verbal communication skills. Ability to effectively articulate complex information across all levels of an organization, including senior leadership and non-clinical/technical audiences. Strong presentation skills.
• Strong organization and prioritization skills. Ability to manage multiple projects simultaneously and consistently meet deadlines.
• Self-starter able to produce quality results based off strong decision-making skills.
• Effective time management and organizational skills with the ability to prioritize initiatives, align appropriate resources, clearly articulate expectations to others, and motivate teams in order to achieve success.
• Adaptable and flexible with change and also have the ability to effectively lead teams through change.
• Understanding of applicable rules, regulations, and guidelines. Must be aware of implications to department.

Preferred Qualifications:

• MBA.
• Prior experience with pharmacy claims software.
• Success with end-to-end management of complex programs from inception through execution and ongoing optimization.
• Knowledge of accreditation standards, PBM contracts, Part D rules and regulations.
• Strategic planning experience.

What you will do as a Team Leader of Pharmacy Clinical Programs:

a. Provide day-to-day leadership of financial and human resources, primarily focusing on employee and leader coaching, development, performance improvement, coordination and budgeting for multiple staff, and departments specific functions/services.

b. Lead ongoing implementation and maintenance of clinically appropriate and cost-effective programs to help control the escalating costs of pharmaceuticals and utilization across all lines of business including but not limited to formulary and utilization management strategies, benefit coding, website updates, member and provider communications, and internal training.

c. Develop and coordinate appropriate drug therapy interventions that demonstrate quality improvement, reduction in the cost of care, and improved outcomes. Actively identify and make recommendations regarding ideas to improve the quality effectiveness and efficiency of pharmacy services offered by the health plan.

d. Work collaboratively with pharmacists, pharmacy technicians and physicians to meet the goals and objectives of the pharmacy program. Direct and support internal ad hoc pharmacy management projects, as well as projects with the contracted pharmacy benefit manager, as needed.

e. Facilitate Wellmark's P&T committee review and new to market medication evaluation processes. Conduct research on drug therapies and pharmacogenomics and develops evidence-based criteria for use and coverage under medical and pharmacy benefits.

f. Perform clinical surveillance of FDA decisions and analyze data to determine overall program effectiveness and identify opportunities for improvement.

g. Coach and mentor other Clinical Pharmacists on business navigation and pharmaceutical trends.

h. Maintain all departmental policies and procedures related to drug management processes.

i. Comply with regulatory standards, accreditation standards and internal guidelines, remain current and consistent with the standard pertinent to pharmaceuticals.

j. Oversight of QHP submission, maintenance of formulary, and ensuring compliance with Essential Health Benefit (EHB) requirements.

k. Other duties as assigned.

This job requires a non-compete agreement.

An Equal Opportunity Employer

The policy of Wellmark Blue Cross Blue Shield is to recruit, hire, train and promote individuals in all job classifications without regard to race, color, religion, sex, national origin, age, veteran status, disability, sexual orientation, gender identity or any other characteristic protected by law.

Applicants requiring a reasonable accommodation due to a disability at any stage of the employment application process should contact us at [email protected]

Please inform us if you meet the definition of a "Covered DoD official".

At this time, Wellmark is not considering applicants for this position that require any type of immigration sponsorship (additional work authorization or permanent work authorization) now or in the future to work in the United States. This includes, but IS NOT LIMITED TO: F1-OPT, F1-CPT, H-1B, TN, L-1, J-1, etc. For additional information around work authorization needs please refer to the following resources:Nonimmigrant Workers and Green Card for Employment-Based Immigrants