VP Pharmacy Services

🔥 5 minutes ago

🦞 Maine – Remote

🦞 Maine – Remote

💵 $286.1k - $353.4k / year

⏰ Full Time

🔴 Lead

💊 Pharmacist

👻 Ghost score 0%

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Martin's Point Health Care

WebsiteLinkedInAll Job Openings

501 - 1000 employees

🛡️ Insurance

📦 Logistics

💼 Consulting

Insurance • Logistics • Consulting

Martin's Point Health Care is a healthcare organization committed to serving its local communities through high-quality primary and specialty care services. The organization places a strong emphasis on creating a positive workplace culture, recognizing employee contributions, and fostering workforce diversity. Martin's Point Health Care offers a range of career opportunities across various departments, from healthcare providers to corporate roles, and supports employee growth through competitive compensation, development programs, and generous perks. Additionally, the company is recognized for its community impact efforts, raising significant funds for community organizations and encouraging employee volunteerism.

📋 Description

• Provides strategic and operational leadership for the Pharmacy division • 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 • Prepares for the CMS Medicare Advantage bid process and ensures compliance with vendor, payer, federal, state, and accreditation standards • 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 • Partners across Pharmacy, Finance, Nursing, Medicine, Population Health, Practice, and other divisions • Provides leadership for pharmacy technology, systems optimization, and workforce planning • Oversees technology assessment, software testing and implementation, operational system enhancements, staffing model development, and recruitment planning • Serves as primary representative and spokesperson for the Pharmacy division • Builds internal and external relationships with patients, members, providers, and other stakeholders • Provides guidance on pharmacy market trends, legislative and regulatory developments, and consultant deliverables

🎯 Requirements

• BS Pharmacy or PharmD required • Must possess Maine and New Hampshire pharmacy license (or eligible) • 10 years' experience including managed care experience and retail pharmacy experience • 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 • 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 • Strong understanding of drug pipeline trends and factors affecting pharmacy cost and utilization • Excellent oral and written communication skills • Must possess Maine and New Hampshire pharmacy license (or eligible) • This position is not eligible for immigration sponsorship

🏖️ Benefits

• medical insurance • dental insurance • vision insurance • retirement savings with employer contributions • paid time off • volunteer time off • pie day • other employee benefits