Director, Clinical Pharmacy – Stars Performance

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Devoted Health

WebsiteLinkedInAll Job Openings

1001 - 5000 employees

Founded 2017

🏥 Healthcare

⚕️ Healthcare Insurance

🧘 Wellness

Healthcare • Healthcare Insurance • Wellness

Devoted Health is a healthcare company that offers Medicare Advantage plans designed to provide comprehensive health coverage with added benefits like dental, eyewear, gym memberships, and prescription drugs at competitive rates. The company emphasizes member support and service, ensuring that clients can easily navigate their benefits and access needed healthcare services. Devoted Health is committed to helping customers save money and enhance their health and wellness through a complete package of benefits and support.

📋 Description

• Own the performance trajectory of the full clinical pharmacy Star portfolio, including medication adherence measures, SUPD, Poly-ACH, and COB • Forecast measure trajectories against projected cut points and identify risks months before year-end scores • Translate performance analysis into daily, weekly, and monthly operating directives for internal teams and vendors • Serve as the authoritative clinical voice on pharmacy quality • Track regulatory specification changes and clinical guideline shifts and interpret operational implications • Lead peer-to-peer dialogue with clinical leaders within Devoted and its provider network • Monitor CMS measure development, display-page measures, and the measure developer pipeline • Build data and operational capability for future measures while they are still on display • Interpret Advance Notices, Proposed Rules, and Final Rules and explain their impact for Devoted • Design organization-wide strategies to achieve 5-Star performance across clinical pharmacy measures • Identify opportunities to reduce friction in members’ healthcare journeys • Manage operating KPIs and clinical outcome metrics with internal teams and external partners, including the PBM • Design and implement clinical and care coordination interventions • Guide initiatives from pilot through full-scale implementation across members, providers, and pharmacy networks • Evaluate vendors and platforms for adherence stratification, pharmacist-led intervention, and pharmacy network engagement • Drive execution through direct management and influence while enabling and supporting teams • Translate complex operational goals into daily workflows

🎯 Requirements

• PharmD or equivalent clinical degree • 7+ years of progressive leadership experience in managed care, a health plan, or a PBM • Dedicated ownership of Medicare Advantage and Part D quality programs • Documented, quantifiable track record of improving clinical pharmacy Stars measures in a volatile cut point environment • Ability to manipulate raw data, draft workflows, and audit vendor call dispositions • Advanced analytical acumen to identify root causes of non-adherence and design targeted, cost-effective interventions • Comfort with business intelligence tooling and opportunity sizing • Demonstrated leadership impact and ability to influence outcomes across organizational levels • Experience with direct management, cross-functional project leadership, or matrix reporting relationships • Ability to build consensus without formal authority • Ability to conduct nuanced clinical discussions and influence prescribing behavior • Ability to learn quickly in complex clinical and operational domains • Curiosity about emerging technologies and pragmatic approach to using them • Experience using LLMs to build complex prompts and tools is a strong plus • Skill and rigor in using and analyzing data, including understanding open versus closed periods, denominator shifts, ranges, and probabilities

🏖️ Benefits

• Employer sponsored health, dental and vision plan with low or no premium • Generous paid time off • $100 monthly mobile or internet stipend • Stock options for all employees • Parental leave program • 401K program • Additional total rewards package offerings • Equal opportunity and supportive work environment