Government Specialty Pharmacy Director

Blue Cross Blue Shield Association

Director providing strategic leadership and oversight for specialty pharmacy benefit serving federal members. Collaborating with executive stakeholders to ensure optimal clinical outcomes and member experience.

Posted 4/23/2026full-timeRemote • New York, Oregon, Virginia • 🇺🇸 United StatesLead💰 $141,980 - $204,225 per yearWebsite

About the role

Key responsibilities & impact

Provide strategic leadership and oversight for the specialty pharmacy benefit serving a large federal member population
Lead the overall administration, operational delivery, regulatory compliance, and program performance
Serve as the enterprise owner of the specialty pharmacy benefit strategy for the Federal Employee Program
Build and maintain trusted partnerships with federal program leadership, senior internal stakeholders, and vendor partners
Lead executive program reviews and strategic discussions, presenting insights on program performance, emerging risks, and opportunities for improvement
Provide leadership across clinical, operational, financial, analytics, and PBM teams
Manage high-priority escalations and complex issues
Provide strategic oversight and governance of the specialty pharmacy benefit
Guide the planning, implementation, and continuous improvement of specialty pharmacy benefit programs
Monitor program performance through key operational, clinical, and service metrics
Ensure the specialty pharmacy program operates in full compliance with federal regulations, contractual obligations, and program governance standards
Provide strategic oversight of PBM and specialty pharmacy vendor relationships
Lead cross-functional teams responsible for implementing specialty pharmacy benefit updates, program enhancements, and regulatory changes
Leverage specialty pharmacy claims data, utilization trends, and operational metrics to evaluate program performance

Requirements

What you’ll need

Bachelor's Degree in Pharmacy, Health Care Administration, Business or related field; or equivalent experience
Master's Degree (MBA or PharmD preferred)
15+ Years Experience in account management, pharmacy benefit administration, PBM operations, specialty pharmacy, or federal health care program oversight
Strong understanding of specialty benefit design, utilization management, clinical programs, and PBM operations
Experience supporting, managing, or administering Federal programs (e.g., Federal Employee Program, TRICARE, VA, DoD, or other federally regulated healthcare benefits)
Direct experience with the Federal Employee Program (FEP), OPM requirements, or similar federal benefit environments preferred
Familiarity with specialty pharmacy workflows, prior authorization programs, and limited-distribution networks preferred
Knowledge of federal regulatory requirements, audit standards, and healthcare program compliance preferred
Demonstrated ability to manage large, complex accounts with multiple stakeholders
Excellent communication, presentation, and executive-facing engagement skills
Ability to interpret and translate pharmacy data into actionable insights
Experience leading cross-functional projects or program implementations.

Benefits

Comp & perks

Paid time off
11 holidays
Medical/dental/vision insurance
Generous 401(k) matching
Lifestyle spending account
Annual bonus incentive pay

ATS Keywords

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Applicant Tracking System Keywords

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Hard Skills & Tools

pharmacy benefit administrationPBM operationsspecialty pharmacyutilization managementclinical programsdata analysisprogram performance monitoringregulatory complianceprogram governanceaccount management

Soft Skills

strategic leadershipcommunication skillspresentation skillsexecutive engagementpartnership buildingproblem-solvingcross-functional team leadershipstakeholder managementanalytical thinkingcontinuous improvement

Certifications

Bachelor's Degree in PharmacyBachelor's Degree in Health Care AdministrationBachelor's Degree in BusinessMaster's Degree (MBA)PharmD