The client is seeking a Director of Pharmacy to lead the strategic vision and operational execution of pharmacy benefit programs. This role is responsible for end-to-end pharmacy benefit design and formulary management, including pharmacy operations, PBM partnerships, utilization management, and quality improvement initiatives. The director will focus on clinical excellence, financial sustainability, regulatory compliance, and member-centered outcomes by optimizing medication access, adherence, cost savings, and overall pharmacy performance across multiple lines of business.
The Director of Pharmacy will provide strategic oversight of pharmacy benefit operations, including formulary strategy, benefit design, utilization management, and cost containment initiatives. Responsibilities include overseeing PBM performance and contract compliance, leading formulary governance and pharmacy/therapeutics committee activities, and developing utilization management protocols such as prior authorization oversight and medication adherence programs. The role will also manage pharmacy staff and lead program initiatives related to specialty pharmacy, biosimilars, opioid safety, behavioral health integration, and 340B strategy, while monitoring pharmacy financial performance, rebate administration, and budget management.
Qualifications include a Doctor of Pharmacy degree and strong knowledge of managed care pharmacy, pharmacy benefit design, formulary management, PBM operations, and utilization management. The role requires at least 5+ years of pharmacy department management experience within a managed care, PBM, Medicare, or Medicaid environment, with prior director-level leadership experience preferred. Active pharmacist licensure is required, and the director is expected to ensure compliance with Medicare, Medicaid, and other applicable regulatory requirements while maintaining pharmacy policies, procedures, and documentation standards. The director will also present operational, financial, and strategic reports to executive leadership and governance committees and lead cross-functional projects with legal, finance, quality, care management, and operational teams.