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VP Pharmacy Services

🔥 23 hours ago

🦞 Maine, New Hampshire – Remote

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đź’µ $286.1k - $353.4k / year

⏰ Full Time

đź”´ Lead

đź’Š Pharmacist

đź‘» Ghost score 0%

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Logo of Martin's Point Health Care

Martin's Point Health Care

501 - 1000 employees

🛡️ Insurance

📦 Logistics

đź’Ľ 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.

đź“‹ Description

• 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

🏖️ Benefits

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

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