Remote Director, Pharmacy Quality & Part D Stars

Alignment Health

78d • Remote

About The Position

The Remote Director, Pharmacy Quality and Part D Stars is a key leader within the Pharmacy Department, supporting the MAPD plan’s efforts to advance Part D Star Ratings and pharmacy quality measures that drive member outcomes. The Director will design and lead targeted pharmacy initiatives to advance Stars performance, oversee PBM and vendor performance, and ensure alignment with organizational goals. Success in this role will be defined by the ability to drive cross-functional collaboration and deliver measurable improvements in pharmacy quality outcomes and member experience.

Requirements

• 7+ years of experience in Medicare Part D, Stars, or pharmacy quality, including at least 5 years in leadership roles.
• Bachelor’s degree required
• Demonstrated success improving CMS Star Ratings through pharmacy-driven initiatives and PBM/vendor collaboration.
• Deep knowledge of CMS Part D Stars methodology, pharmacy quality measures, and regulatory updates that impact performance.
• Expertise in leveraging data analytics to guide forecasting, strategy, and decision-making.
• Proven ability to lead teams, align cross-functional efforts, and communicate effectively with senior leadership.
• Proven ability to anticipate trends, adapt strategies, and deliver measurable improvements in Stars performance and member outcomes.
• Ability to communicate positively, professionally and effectively with others; provide leadership, teach and collaborate with others.
• Effective written and oral communication skills; ability to establish and maintain a constructive relationship with diverse members, management, employees and vendors;
• Ability to prioritize multiple tasks; advanced problem-solving; ability to use advanced reasoning to define problems, collect data, establish facts, draw valid conclusions, and design, implement and manage appropriate resolution.
• Effective problem solving, organizational and time management skills and ability to work in a fast-paced environment.

Nice To Haves

• Advanced degree preferred (PharmD, RN, MPH, MBA, or related field)

Responsibilities

• Create and implement a multi-year pharmacy Stars and quality roadmap, aligned with CMS methodology and enterprise Stars goals.
• Monitor CMS methodology updates, assess their impact on pharmacy measures, and integrate changes into Stars strategies and operations.
• Anticipate emerging trends and proactively adjust strategies to maintain and enhance pharmacy STARs performance.
• Lead the development and execution of pharmacy-driven strategies to improve Stars measures and quality outcomes, including medication safety, adherence, MTM, SUPD, SPC, and member experience.
• Monitor current performance and evaluate interventions, with added focus on areas of greatest opportunity or risk.
• Lead both internal pharmacy programs and PBM/vendor partnerships to ensure high performance and accountability across all Stars-related measures.
• Represent Pharmacy in PBM, vendor, and cross-functional forums, ensuring strategies are aligned and Stars performance expectations are achieved.
• Build and deliver dashboards, forecasts, and executive reports that translate complex data into actionable insights and recommendations, highlighting risks and guiding Stars performance decisions.
• Lead, mentor, and develop a high-performing team, fostering a culture of accountability, innovation, continuous improvement, and optimized workflows that support Stars performance.

Benefits

• Alignment Health is an Equal Opportunity/Affirmative Action Employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, national origin, disability, age, protected veteran status, gender identity, or sexual orientation.

What This Job Offers

• Job Type: Full-time
• Career Level: Director