Director, Pharmacy
About The Position
We're seeking a Director, Part D Stars Strategy to join our Government Pharmacy Programs Department. The Director, Part D Stars Strategy, is responsible for driving the day to day strategy, execution, and performance management of Medicare Part D Star Ratings. This role serves as the operational and analytical lead for Part D Stars, translating CMS requirements and performance insights into actionable improvement initiatives that support the organization’s goal of achieving and sustaining 4+ Star performance. You will partner closely with Pharmacy Operations, Analytics, PBM Partners, Product, and Stars team, and plays a critical role in enabling informed decision making through data analytics, forecasting, segmentation, and program oversight. The Director will also lead our internal Quality & Stars team, overseeing team performance, professional development, progress against goals, and ensuring attainment of Part D Stars targets.
Requirements
- Bachelor's degree or advanced degree (where required)
- 8+ years of experience in related field. In lieu of degree, 10+ years of experience in related field.
- Strong working knowledge of Medicare Part D Stars measures, methodology, and CMS technical specifications.
- Experience with MTM programs, adherence interventions, and pharmacy operations.
- Experience with pharmacy related CAHPS measures and how to drive customer experience improvements to positively impact CAHPS.
- Familiarity with CMS systems and regulatory submissions (e.g., HPMS).
- Experience using tools such as Power BI or Tableau.
- Demonstrated success managing complex, cross‑functional teams.
- Strong analytical and problem‑solving skills with experience interpreting performance data and forecasts.
- Effective written and verbal communication skills, including experience presenting to senior leaders.
Nice To Haves
- Master’s degree in Public Health, Pharmacy, Analytics, Business, or a related field preferred.
- 5–8 years of experience in Medicare Part D Stars, pharmacy quality, PBM operations, or health plan analytics.
- PharmD, MPH, MS in Analytics, or similar advanced degree.
Responsibilities
- Lead the execution of the Medicare Part D Stars strategy in alignment with organizational goals and CMS technical specifications.
- Accountable for performance management of Part D Stars measures, including adherence, medication safety, MTM, pharmacy quality measures, and leading indicators/KPIs.
- Lead, develop, coach and mentor internal Part D Quality & Stars team to achieve enterprise Part D Stars targets.
- Assess Part D Stars outsourcing opportunities to improve performance as needed.
- Translate annual CMS updates into operational plans and performance targets.
- Support multi‑year improvement planning and monitor progress against Stars goals.
- Direct development and maintenance of Stars performance dashboards and reporting for leadership and operational teams.
- Partner with Stars and analytics teams to develop forecasting models, test & learn scenarios, member & provider segmentation, Stars cut point scenarios, and risk assessments.
- Monitor measure trends and identify emerging risks or improvement opportunities.
- Collaborate with pharmacy operations, PBM partners, clinical programs, Stars and Product teams, and vendors to implement Stars improvement initiatives.
- Partner with compliance and regulatory teams to support audit readiness and CMS inquiries.
- Serve as a trusted advisor to leaders by clearly communicating performance insights and recommended actions.
Benefits
- Medical, dental, and vision coverage along with numerous health and wellness programs
- Parental leave and support plus adoption and surrogacy assistance
- Career development programs and tuition reimbursement for continued education
- 401k match including an annual company contribution
- Annual Incentive Bonus
- Paid Time Off (PTO)
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What This Job Offers
Job Type
Full-time
Career Level
Director
