Company Overview
At CareFirst, our name reflects our mission—putting care first in everything we do. More than 3.5 million people trust us to support their healthcare needs, and we take that responsibility to heart.
Our vision is simple: healthcare should be affordable, accessible, and easy to navigate. We’re building a system that delivers the same level of care and service we would expect for ourselves and our loved ones.
Every day, we strive to make a positive impact in the communities where we live and work. We approach every challenge with empathy and urgency—simplifying complex processes, offering personalized solutions, and driving innovation that truly makes a difference.
Position Summary
We’re seeking a skilled Clinical Pharmacist – Specialty Drug Strategy to join our team in Baltimore, MD. In this pivotal role, you’ll lead strategic clinical initiatives with a focus on specialty medications across both pharmacy and medical benefits. Your work will help shape drug coverage policies, optimize pricing and reimbursement models, and support rebate program execution—all in collaboration with cross-functional teams in a matrixed environment.
Key Responsibilities
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Evaluate and recommend rebate opportunities that enhance cost savings.
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Develop and maintain drug management policies, ensuring alignment with internal oversight committees and regulatory compliance.
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Monitor industry trends to design and implement effective specialty drug strategies for cost control and clinical effectiveness.
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Partner with internal stakeholders and external vendors to align benefit design with market innovations.
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Serve as a subject matter expert, offering insights on specialty drug utilization, cost mitigation, and market evolution.
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Prepare and deliver presentations and strategic communications on pharmacy-related topics to diverse audiences.
Required Qualifications
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Education: Doctor of Pharmacy (PharmD) degree from an accredited institution.
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Licensure: Active Pharmacist license in any U.S. state or the District of Columbia.
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Experience: Minimum of 5 years in a clinical pharmacy role, preferably within a managed care setting.
Preferred Qualifications
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In-depth understanding of specialty drug management under both pharmacy and medical benefits across Commercial, Medicare, and Medicaid plans.
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Demonstrated experience with drug pricing strategies, reimbursement models, and market dynamics.
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Certified Specialty Pharmacist (CSP) credential is a plus.
Knowledge, Skills, and Abilities
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Strong clinical judgment and analytical thinking in a strategic context.
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Independent worker with the ability to thrive in collaborative, team-based environments.
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Exceptional communication skills, including the ability to deliver impactful presentations.
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Proficiency with clinical systems and data analysis tools.
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Balanced perspective combining clinical expertise with business strategy.
Compensation & Benefits
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Salary Range: $120,160 – $214,786 (commensurate with education, experience, and internal equity).
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Compensation is determined by a variety of factors including responsibilities, experience, location, and market conditions.
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Comprehensive benefits package including health plans, 401(k) with company contributions, and incentive opportunities (eligibility applies).
Physical and Legal Requirements
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Primarily sedentary role with occasional walking or standing.
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Regular use of hands for typing and handling small items.
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Must be able to lift up to 25 lbs.
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Must disclose any restrictions that impact eligibility to work on Federal health care programs.
Work Authorization
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Must be authorized to work in the U.S. Sponsorship is not available for this position.
About CareFirst BlueCross BlueShield
At CareFirst, we take our responsibility seriously—serving over 3.5 million individuals with healthcare solutions that are affordable, accessible, and easy to use. Our team works every day to simplify the complex, develop innovative solutions, and make a meaningful impact in the communities we serve.
Equal Opportunity Employer
CareFirst is proud to be an Equal Opportunity Employer. We provide equal employment opportunities to all qualified candidates without regard to race, color, religion, gender, sexual orientation, gender identity, national origin, age, disability, veteran status, or genetic information.