Program Manager, Principal

Your Role

The Pharmacy Services team is redefining how Blue Shield offers high quality, affordable, safe and convenient access to necessary prescription drugs. The Principal Program Manager, Rx Claim Exchange will report to the Senior Director, Program and Project Management. In this role you will be the business Product Owner responsible for the Rx Claim Exchange Agile Product Team. The Rx Claim Exchange Agile Product Team is one of many teams that makes up the Pharmacy Product Model. You will work cross functionally with other Pharmacy Services teams, IT, and our Service Providers and external vendors to manage inbound and outbound claim data files, claim data APIs, and cloud and on-prem claim data sources, including new implementations, ongoing operations/enhancements, and incident management.

Your Knowledge and Experience

• Requires a bachelor’s degree or equivalent experience
• Requires at least 10 years of prior relevant experience
• Requires experience working with Pharmacy Benefits Manager (PBMs) and pharmacy Claims, Membership, Prior Authorization, Benefits, Pharmacy Networks and Providers, Rebate, and other relevant data
• Demonstrates strong data analysis and data interpretation skills
• Demonstrates strong ability to influence, collaborate, and build relationships with key stakeholders, vendors, and cross-functional teams
• Possesses effective verbal and written communication skills including the ability to create business requirements and translate into technical deliverables
• Experience with Agile/Scrum processes and principals
• Experience as a Product Owner is a plus