Independence Blue Cross · 1 day ago
Manager Clinical Pharmacy
Philadelphia, Pennsylvania
Full-time
Onsite
Senior Level
7+ years expIndependence Blue Cross is a healthcare organization seeking a Manager of Clinical Pharmacy Services to provide strategic leadership and operational oversight for formulary and clinical pharmacy programs. The role involves leading a team of clinical pharmacists, ensuring compliance with regulations, and driving initiatives to enhance patient safety and optimize medication use.
Health CareHealth InsuranceInsuranceMedical
Responsibilities
Lead the execution and support the development of market‑level clinical pharmacy strategies aligned with enterprise priorities
Provide clinical leadership for enterprise‑wide formulary strategy and medical benefit drug policy development
Ensure clinically appropriate and cost-effective formulary by providing appropriate drug review and formulary placement based on clinical and financial data
Develop and implement direct patient care strategy and clinical pharmacy programs for the market
Drives compliance in the delivery of clinical pharmacy services
Drives market pharmacy financial performance
Drives the execution of multiple business plans and projects, ensuring business needs are being met
Promotes and supports company policies, procedures, mission, values, and standards of ethics and integrity
Represent Clinical Pharmacy Services in cross‑functional planning meetings and customer‑facing engagements
Provides supervision and development opportunities for associates
Ensure accuracy, integrity, and timeliness of formulary submissions and medical necessity policy reviews
Ensures compliance with all required regulatory guidelines
Oversee the management of the IBX Pharmacy and Therapeutics Committee
Formulary Management Oversight (tasks executed by 2 pharmacists)
Oversee medical necessity policy management and strategy
Ensure readiness for internal/external audits and support accreditation maintenance (CMS, URAC, NCQA)
Ensure clinical integrity of medical necessity reviews
Oversee integration of clinical programs with digital platforms and analytics tools to support clinical decision‑making
Identify strategic opportunities to maintain cost-effectiveness and improve clinical effectiveness
Coordinate Strategic positioning of clinical programs including clinical customer support
Coordinate Quality and Product initiatives
Qualification
Required
Doctor of Pharmacy or Bachelor of Science Degree in Pharmacy plus 7+ years of relevant clinical experience
Active State Pharmacy License
More than 5 years practice experience in a managed care or corporate setting
Experience supporting Medicare STAR ratings or quality improvement programs
Preferred
Current knowledge and expertise in clinical pharmacology, disease management and managed care
Minimum 5-7 years of leadership or team lead experience in managed care, clinical pharmacy programs, or formulary management
Experience with clinical analytics, pharmacy benefit design, or affordability initiatives
Self-management Skills – self-motivated, organized, detail oriented and manages time and resources effectively. Must be able to work independently in a collaborative environment, be self-directed and possess excellent organizational and time management skills
Computer/Technology Competency: Proficient in use of Microsoft Word, Excel, and Outlook
Strong interpersonal, communication, administrative, leadership, problem solving and decision-making skills
Medicare related: Working knowledge and understanding of CMS Medicare Part D requirements
Company
Independence Blue Cross
The leading health insurer in southeastern Pennsylvania. It is a sub-organization of Independence Blue Cross.
5001-10000 employees
H1B Sponsorship
Independence Blue Cross has a track record of offering H1B sponsorships. Please note that this does not
guarantee sponsorship for this specific role. Below presents additional info for your
reference. (Data Powered by US Department of Labor)
Distribution of Different Job Fields Receiving Sponsorship
Represents job field similar to this job
Trends of Total Sponsorships
2025 (16)
2024 (2)
2023 (6)
2022 (2)
2021 (6)
2020 (1)
Funding
Current Stage
Late StageLeadership Team
Alexandra Jorgensen
Senior Vice President Human Resources
Joe Geist
SVP & Market President, National
Recent News
Home Health Care News
2026-01-14
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