Managing Director, Clinical Pharmacy Strategy and Execution
About The Position
Job Summary Provides strategic leadership for clinical pharmacy initiatives across all lines of business. Oversee formulary, criteria, and prior authorization activities to ensure timely, compliant, and high-quality service delivery. Accountable for monitoring drug utilization trends, guiding performance standards, and ensuring regulatory compliance to support affordability and member outcomes. Job Responsibilities Clinical Strategy Oversight: Lead the strategic direction, development, and execution of drug management programs, ensuring alignment with enterprise goals and regulatory requirements. Formulary & Coverage Review Program Management: Direct leadership staff responsible for formulary creation, criteria development and mantenance, prior authorization evaluations, and utilization management monitoring. Policy & Accreditation Governance: Oversee development and maintenance of clinical pharmacy policies and ensure compliance with accreditation standards (e.g., URAC, NCQA, CMS). Leadership Development: Lead and develop a high-performing team, fostering a culture of accountability, engagement, and continuous improvement, and professional growth. Cross-Functional Collaboration: Coordinate with pharmacy benefit strategy leaders and corporate stakeholders to deliver competitive and cost-effective clinical services. Audit Readiness: Lead audit preparation and compliance initiatives to ensure coverage review operations meet internal and external standards. Innovation & Value Delivery: Ensure clinical functions meet expectations for value and affordability, driving continuous improvement and market responsiveness.
Requirements
- Doctor of Pharmacy (PharmD) degree required
- Minimum 10 years of managed care, PBM, and/or clinical experience required
- Minimum 5 years of supervisory/leadership responsibilities required
- Licensed in Tennessee to practice pharmacy, or eligible for licensure in the state of Tennessee to practice pharmacy
- Ability to lead coverage review operations and ensure compliance
- Expertise in policy development and audit readiness
- Skill in driving process improvements for service quality
- Strength in cross-functional collaboration with pharmacy and corporate teams
- Leadership in building and mentoring operational teams
Responsibilities
- Clinical Strategy Oversight: Lead the strategic direction, development, and execution of drug management programs, ensuring alignment with enterprise goals and regulatory requirements.
- Formulary & Coverage Review Program Management: Direct leadership staff responsible for formulary creation, criteria development and mantenance, prior authorization evaluations, and utilization management monitoring.
- Policy & Accreditation Governance: Oversee development and maintenance of clinical pharmacy policies and ensure compliance with accreditation standards (e.g., URAC, NCQA, CMS).
- Leadership Development: Lead and develop a high-performing team, fostering a culture of accountability, engagement, and continuous improvement, and professional growth.
- Cross-Functional Collaboration: Coordinate with pharmacy benefit strategy leaders and corporate stakeholders to deliver competitive and cost-effective clinical services.
- Audit Readiness: Lead audit preparation and compliance initiatives to ensure coverage review operations meet internal and external standards.
- Innovation & Value Delivery: Ensure clinical functions meet expectations for value and affordability, driving continuous improvement and market responsiveness.
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What This Job Offers
Job Type
Full-time
Career Level
Director
Education Level
Ph.D. or professional degree
