Director, Pharmacy

This is a fully remote position, open to applicants in Kentucky, +3 more states.

📋 Description

• Oversee the daily strategy, implementation, and performance monitoring of Medicare Part D Star Ratings.

• Spearhead the execution of the Medicare Part D Stars strategy in accordance with organizational objectives and CMS technical requirements.

• Manage Part D Stars metrics, which include adherence, medication safety, MTM, pharmacy quality measures, and key performance indicators (KPIs).

• Lead, cultivate, coach, and mentor the internal Part D Quality & Stars team.

• Evaluate outsourcing possibilities for Part D Stars initiatives.

• Convert annual CMS updates into operational plans and performance goals.

• Assist in long-term improvement planning and track progress towards Stars objectives.

• Oversee the creation and upkeep of Stars performance dashboards and reporting metrics.

• Develop forecasting models, test-and-learn scenarios, member and provider segmentation, Stars cut-point scenarios, and risk assessments.

• Monitor measure trends and pinpoint emerging risks or opportunities for enhancement.

• Collaborate with pharmacy operations, PBM partners, clinical programs, Stars and Product teams, and vendors.

• Work alongside compliance and regulatory teams to ensure audit preparedness and address CMS inquiries.

• Provide guidance to leaders by sharing performance insights and suggested actions.

• Supervise team performance, professional growth, progress towards goals, and achievement of Part D Stars targets.

⛳️ Requirements

• Bachelor’s degree or advanced degree (as required).

• Over 8 years of experience in a relevant field.

• Alternatively, 10+ years of experience in a related field may be accepted in place of a degree.

• Comprehensive knowledge of Medicare Part D Stars measures, methodologies, and CMS technical requirements.

• Proficient experience with MTM programs, adherence interventions, and pharmacy operations.

• Experience with pharmacy-related CAHPS measures and enhancing customer experience.

• Familiarity with CMS systems and regulatory submissions, including HPMS.

• Proficient in using Power BI or Tableau.

• Proven success in managing complex, cross-functional teams.

• Strong analytical and problem-solving abilities, with experience in interpreting performance data and forecasts.

• Excellent written and verbal communication skills, including the ability to present to senior leaders.

• Authorized to work in the United States.

🏝️ Benefits

• Work-life balance, flexibility, and autonomy.

• Medical, dental, and vision coverage.

• Health and wellness programs.

• Parental leave and support.

• Adoption and surrogacy assistance.

• Career development programs.

• Tuition reimbursement for ongoing education.

• 401k match, including an annual company contribution.

• Annual Incentive Bonus.

• Paid Time Off (PTO).

• Competitive health benefits and wellness programs.