Government Specialty Pharmacy Director

This is a fully remote position, open to applicants in Nebraska, +2 more states.

📋 Description

• Deliver strategic leadership and oversight for the specialty pharmacy benefit catering to a substantial federal member population.

• Direct the overall administration, operational execution, regulatory adherence, and program performance.

• Act as the enterprise leader for the specialty pharmacy benefit strategy within the Federal Employee Program.

• Establish and nurture trusted relationships with federal program leadership, senior internal stakeholders, and vendor partners.

• Lead executive program reviews and strategic discussions, offering insights into program performance, emerging risks, and areas for enhancement.

• Provide leadership across clinical, operational, financial, analytics, and PBM teams.

• Handle high-priority escalations and complex issues effectively.

• Ensure strategic oversight and governance of the specialty pharmacy benefit.

• Guide the planning, implementation, and ongoing enhancement of specialty pharmacy benefit programs.

• Track program performance through key operational, clinical, and service metrics.

• Guarantee that the specialty pharmacy program adheres to federal regulations, contractual commitments, and program governance standards.

• Oversee PBM and specialty pharmacy vendor relationships strategically.

• Lead cross-functional teams tasked with implementing specialty pharmacy benefit updates, program improvements, and regulatory modifications.

• Utilize specialty pharmacy claims data, utilization trends, and operational metrics to assess program performance.

⛳️ Requirements

• Bachelor's Degree in Pharmacy, Health Care Administration, Business, or a related field; or equivalent professional experience.

• Master's Degree (preferably MBA or PharmD).

• Over 15 years of experience in account management, pharmacy benefit administration, PBM operations, specialty pharmacy, or oversight of federal health care programs.

• Strong comprehension of specialty benefit design, utilization management, clinical programs, and PBM operations.

• Experience in supporting, managing, or administering Federal programs (e.g., Federal Employee Program, TRICARE, VA, DoD, or other federally regulated healthcare benefits).

• Preferred direct experience with the Federal Employee Program (FEP), OPM requirements, or similar federal benefit environments.

• Familiarity with specialty pharmacy workflows, prior authorization programs, and limited-distribution networks is preferred.

• Knowledge of federal regulatory requirements, audit standards, and healthcare program compliance is preferred.

• Proven ability to manage large, complex accounts involving multiple stakeholders.

• Exceptional communication, presentation, and executive-facing engagement skills.

• Capability to interpret and convert pharmacy data into actionable insights.

• Experience in leading cross-functional projects or program implementations.

🏝️ Benefits

• Paid time off.

• 11 holidays.

• Medical, dental, and vision insurance.

• Generous 401(k) matching.

• Lifestyle spending account.

• Annual bonus incentive pay.