- Provides strategic and operational leadership for the Pharmacy division to achieve organizational goals related to financial performance, sustainability, growth, and pharmaceutical management targets
- Directs the full scope of pharmacy operations, including formulary management, prior authorizations, formulary exceptions, medication adherence, patient accounting, billing practices, vendor billing oversight, and daily systems operations
- Ensures Pharmacy division readiness for payer, regulatory, contractual, and accreditation requirements, including preparation for the CMS MA bid process
- Establishes and oversees pharmacy performance metrics, data analysis, and quality improvement initiatives
- Ensures pharmacy-related policies are clinically sound with EBM criteria and appropriate utilization management activities, such as step therapy
- Partners across Pharmacy, Finance, Nursing, Medicine, Population Health, Practice, and other divisions to align clinical, administrative, and business processes
- Provides leadership for pharmacy technology, systems optimization, and workforce planning, including technology assessment, software testing and implementation, system enhancements, staffing model development, and recruitment planning
- Serves as the primary representative and spokesperson for the Pharmacy division, building internal and external relationships
- Provides guidance regarding pharmacy market trends, legislative and regulatory developments, and consultant deliverables
- Manages Medicare Advantage and USFHP pharmacy-related programs, PBM and pharmacy vendors, Mail Order Pharmacy, contract compliance, rebate optimization, CMS and USFHP compliance, STARS and HEDIS performance, and pharmacy spending
Requirements
- BS Pharmacy or PharmD required
- PharmD, MBA preferred
- Must possess Maine and New Hampshire pharmacy license (or eligible)
- 10 years' experience including managed care experience (i.e., PBM, HMO, group practice) and retail pharmacy experience (i.e., chain, independent, mail order)
- Experience leading complex cross-functional projects and implementations
- Experience with pharmacy vendor management, contract oversight, and review of key contractual elements
- Experience supporting Medicare bid development, formulary strategy, or pharmacy financial analysis
- Experience evaluating pharmacy programs and policies from both clinical and financial perspectives
- Experience reviewing financial reports, reconciliations, invoices, and pharmacy trend data
- Strong knowledge of Medicare Part D regulations and the Medicare annual bid process
- Knowledge of pharmacy benefit design, formulary strategy, PBM operations, and pharmacy claims administration
- Knowledge of pharmacy financial drivers, trend analysis, forecasting inputs, and invoice reconciliation processes
- Knowledge of federal and state laws and regulations and applicable accreditation standards
- Ability to evaluate pharmacy policies and initiatives using both clinical and financial business judgment
- Strong understanding of drug pipeline trends and factors affecting pharmacy cost and utilization
- Excellent oral and written communication skills
- Excellent interpersonal skills
- Excellent delegation skills
- Ability to be a critical thinker
- Ability to establish accountability
- Ability to design work processes around customer needs and expectations
- Ability to prioritize
- This position is not eligible for immigration sponsorship
Core Competencies
Demonstrates expertise in pharmacy operations, including formulary management, vendor oversight, and compliance with Medicare regulations. Proven ability to lead cross-functional teams and implement strategic initiatives that enhance financial performance and operational efficiency.
Highest-signal resume keywords
- Pharmacy Operations Management
- Medicare Part D Regulations
- Formulary Strategy Development
- Pharmacy Vendor Management
- Financial Analysis and Reporting
ATS Optimization Keywords
Hard Skills
- Formulary Management
- Prior Authorizations
- Medication Adherence
- Pharmacy Claims Administration
- Financial Reconciliation
- Data Analysis
- Quality Improvement Initiatives
- Contract Oversight
- Pharmacy Benefit Design
- Pharmacy Financial Drivers
Soft Skills
- Excellent Oral Communication
- Excellent Written Communication
- Excellent Interpersonal Skills
- Critical Thinking
- Delegation Skills
Certifications & Qualifications
- BS Pharmacy
- PharmD
- Maine Pharmacy License
- New Hampshire Pharmacy License
Industry Keywords
- Managed Care
- PBM Operations
- HMO
- Mail Order Pharmacy
- CMS Compliance
- USFHP Programs
- STARS Performance
- HEDIS Performance
- Accreditation Standards
- Drug Pipeline Trends
Tools & Technologies
- Pharmacy Technology Systems
- Software Testing and Implementation
- Data Analysis Tools
- Performance Metrics Systems
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VP Pharmacy Services Arbeitgeber: Jobtailor
Als Front Office Supervisor in unserem dynamischen Team bieten wir Ihnen die Möglichkeit, in einem unterstützenden und freundlichen Arbeitsumfeld zu wachsen. Wir legen großen Wert auf die berufliche Entwicklung unserer Mitarbeiter und bieten regelmäßige Schulungen sowie die Chance, Verantwortung zu übernehmen. Unsere Lage ermöglicht es Ihnen, Teil einer lebendigen Gemeinschaft zu sein, während Sie gleichzeitig die Standards unseres Franchise-Partners einhalten und unseren Gästen einen unvergesslichen Aufenthalt bieten.
