VP, Clinical Pharmacy Services
About The Position
Develop, implement and oversee the pharmacy benefit management program across multiple product lines in both centralized and regional environments with multiple locations. Ensure compliance with contractual guidelines of the corporation and health plans impacted by numerous regulatory agencies with complex and often conflicting requirements. Provides enterprise leadership for pharmacy clinical operations, including Pharmacy & Therapeutics (P&T) governance, formulary strategy, clinical policy oversight, and drug pipeline management to support quality, affordability, and regulatory compliance. Leads pharmacy trend management, high-cost therapy strategies, and manufacturer relationship management, including medical rebate strategy and negotiations, to optimize clinical and financial outcomes. Partners cross-functionally with Pharmacy, Product, Actuary, Medical Affairs, Compliance, PHCO, and Market teams to develop and execute enterprise pharmacy strategies that enhance member access and business performance. Oversees strategic planning for emerging therapies, formulary performance, and pharmacy spend management while ensuring readiness for evolving market and regulatory requirements. Evaluate program performance and recommend to State on program changes that would result in improved costs and higher quality. Responsible for developing and attaining pharmacy AOP initiatives and Per Member Per Month (PMPM) goal. Establish the strategic vision, objectives and policies and procedures for the pharmacy program in support of the corporate strategic vision. Participate in internal and external accreditation initiatives, relevant boards, task forces, committees, meetings and other activities. Manage relationships with and provide appropriate oversight of key vendors, including industry leading partners (e.g. ICER) and pharmaceutical companies. Performs other duties as assigned. Complies with all policies and standards.
Requirements
- Bachelor's Degree in Pharmacy required.
- 10+ years of clinical pharmacy care and experience required.
- Thorough knowledge of pharmaceutical care and pharmacy benefit management practices.
- Previous management experience including responsibilities for hiring, training, assigning work and managing performance of staff.
- Or equivalent experience acquired through accomplishments of applicable knowledge, duties, scope and skill reflective of the level of this position.
Nice To Haves
- PharmD preferred.
- Quality improvement experience preferred.
Responsibilities
- Develop, implement and oversee the pharmacy benefit management program across multiple product lines in both centralized and regional environments with multiple locations.
- Ensure compliance with contractual guidelines of the corporation and health plans impacted by numerous regulatory agencies with complex and often conflicting requirements.
- Provide enterprise leadership for pharmacy clinical operations, including Pharmacy & Therapeutics (P&T) governance, formulary strategy, clinical policy oversight, and drug pipeline management.
- Lead pharmacy trend management, high-cost therapy strategies, and manufacturer relationship management, including medical rebate strategy and negotiations.
- Partner cross-functionally with Pharmacy, Product, Actuary, Medical Affairs, Compliance, PHCO, and Market teams to develop and execute enterprise pharmacy strategies.
- Oversee strategic planning for emerging therapies, formulary performance, and pharmacy spend management.
- Evaluate program performance and recommend to State on program changes that would result in improved costs and higher quality.
- Develop and attain pharmacy AOP initiatives and Per Member Per Month (PMPM) goal.
- Establish the strategic vision, objectives and policies and procedures for the pharmacy program.
- Participate in internal and external accreditation initiatives, relevant boards, task forces, committees, meetings and other activities.
- Manage relationships with and provide appropriate oversight of key vendors, including industry leading partners (e.g. ICER) and pharmaceutical companies.
- Perform other duties as assigned.
- Comply with all policies and standards.
Benefits
- competitive pay
- health insurance
- 401K
- stock purchase plans
- tuition reimbursement
- paid time off
- holidays
- a flexible approach to work with remote, hybrid, field or office work schedules
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What This Job Offers
Job Type
Full-time
Career Level
Executive
