VP Managed Care Pharmacy Services

Geisinger•Danville, PA

10d•Onsite

About The Position

Responsible for overall strategy, planning, development, implementation, and supervision of Enterprise Pharmacy managed care pharmacy services for all lines of business. Possesses and maintains the oversight of the managed care pharmacy staff and leadership teams, functioning as a leader and facilitator in a team-based environment. Clearly and effectively articulates in a timely fashion the mission, goals, directions, critical issues, and values to the employees who work within the respective area of responsibility. Oversees and coordinates the operational and clinical programs of the Enterprise Pharmacy managed care pharmacy services and, in collaboration with Chief Pharmacy Officer (CPO), sets the strategic vision for Geisinger’s managed care pharmacy pillar.

Requirements

Master's Degree
Minimum of 7 years-Managerial/Supervisory experience
Minimum of 10 years-Related work experience
Licensed Pharmacist (Pennsylvania)

Responsibilities

Provide operational and clinical oversight and accountability for all managed care pharmacy services, including human resources, financial planning and ongoing growth and development. This includes but is not limited to formulary management, clinical policy development, utilization management operations and pharmacy benefit configuration.
Serve as department liaison and program steward across the organization, with outside constituents, and with strategic partners including pharmaceutical industry partners, pharmacy benefit managers (PBM), legislative groups, other health systems, schools of pharmacy, and professional pharmacy organizations.
Oversee the development, revision, and auditing of applicable policies and operational procedures, compliance with federal and state regulatory requirements (CMS, DHS, etc.) and other standards of practice (NCQA, ACA, etc.).
Lead and chair system-level initiatives and workgroups upon request from executive and system leadership.
Provide direction and guidance for the development and implementation of optimum standards of managed care pharmacy services, pharmacy benefit management services, medication therapy disease management, and medication management processes.
Develop, communicate, and participate in research to enhance the impact of clinical pharmacy and innovative care delivery models providing optimal customized care for Geisinger’s patients.
Ensure collaboration with other departments regarding issues related to managed care pharmacy practices and all aspects of medication management for areas of responsibility.
Serve in oversight capacity in the development and implementation of all strategic, tactical, and business plans to the Director, Assistant Directors and medical directors to coordinate pharmaceutical care for members.
Effectively engage senior Health Plan and Clinical Enterprise executives in support of daily pharmacy operations, implementation, and prioritization of initiatives.
Serve as Secretary on the Health Plan Pharmacy and Therapeutics Committee.
Provide both clinical and operational guidance and oversight for the enhancement and development of new or existing managed care pharmacy services and practice models.
Closely collaborate with the Geisinger Health Plan and our KACO partners on system-wide and multidisciplinary initiatives in support of an effective value-based care practice model.
Explore mutually beneficial collaborations outside of system, including those with schools of pharmacy, private funders, and research grantees.
Accountable for maintaining standards, clinical activities, operational activities and performance measurement tools that meet clinical, operational, and market needs in the areas of clinical practice, operational efficiency, quality, and patient satisfaction.
Accountable for maintaining and communicating standards, clinical activities, operational activities and performance measurement tools that meet clinical, operational, and market needs in the areas of clinical practice, operational efficiency, pharmaceutical procurement, medication utilization, quality, and patient satisfaction.
Assist with the development, implementation, and forecasted financial outcomes, and provide input into business plans and financial pro-forma in concert with the Chief Pharmacy Officer.
Responsible for ensuring the development and implementation of operational contingency plans in concert with the Chief Pharmacy Officer as financial conditions warrant.
Proactively assess and analyze risks/issues that may compromise success of operations or initiatives and develop plans to remove or mitigate them.
Utilize financial or benchmarking reports to monitor all revenue and expense impacting activity related to all areas of oversight, proactively act on this information and report summary information to the CPO.
Collaborate with Human Resources on recruitment and retention activities regarding pharmacy staff.
Provide oversight and guidance for human resource management including development and disciplinary actions.
Collaborate with pharmacy leadership team to ensure that the pharmacy staff utilize their highest skill capacity to facilitate innovations in care delivery across the care continuum for all aspects related to pharmacy services.
Provide administrative, operational, and clinical oversight and guidance for system-wide pharmacy educational programs and processes including pharmacy residency and student programs, collaborative practice, credentialing and continuing professional development of staff.
Coordinate and analyze industry, enterprise and member specific data and intelligence to perform needs assessments and solution development for solutions that integrate care, improve clinical quality, and drive affordability, leveraging enterprise pharmacy assets.
Develop solutions that align with key pillars, including affordability, access, quality, member experience, integrated healthcare, value-based alignment and health equity.
Utilize broad understanding of managed care and PBM knowledge to develop, and/or implement strategies and programs to mitigate cost trend and improve health outcomes.
Manage relationship and provide oversight of key vendor partners responsible for any outsourced programs.