VP Pharmacy Services

This is a fully remote position, open to applicants in Maine.

📋 Description

• Provides strategic and operational leadership for the Pharmacy division.

• Directs the comprehensive range of pharmacy operations, including formulary management, prior authorizations, formulary exceptions, medication adherence, patient accounting, billing practices, vendor billing oversight, and daily systems operations.

• Ensures the Pharmacy division is prepared for payer, regulatory, contractual, and accreditation obligations.

• Prepares for the CMS Medicare Advantage bid process, ensuring compliance with vendor, payer, federal, state, and accreditation standards.

• Establishes and supervises pharmacy performance metrics, data analysis, and quality improvement initiatives.

• Ensures that pharmacy-related policies are clinically sound, adhering to Evidence-Based Medicine (EBM) criteria and appropriate utilization management activities.

• Collaborates with Pharmacy, Finance, Nursing, Medicine, Population Health, Practice, and other divisions.

• Provides leadership in pharmacy technology, systems optimization, and workforce planning.

• Oversees technology assessments, software testing and implementation, operational system enhancements, staffing model development, and recruitment planning.

• Acts as the primary representative and spokesperson for the Pharmacy division.

• Fosters relationships both internally and externally with patients, members, providers, and other stakeholders.

• Offers insights on pharmacy market trends, legislative and regulatory changes, and consultant deliverables.

⛳️ Requirements

• BS in Pharmacy or PharmD is required.

• Must hold a pharmacy license for Maine and New Hampshire (or be eligible).

• A minimum of 10 years of experience, which includes managed care and retail pharmacy experience.

• Proven experience in leading complex cross-functional projects and implementations.

• Experience in pharmacy vendor management, contract oversight, and evaluation of key contractual elements.

• Background in supporting Medicare bid development, formulary strategy, or pharmacy financial analysis.

• Experience in assessing pharmacy programs and policies from both clinical and financial viewpoints.

• Familiarity with reviewing financial reports, reconciliations, invoices, and pharmacy trend data.

• Understanding of Medicare Part D regulations and the Medicare annual bid process.

• Knowledge of pharmacy benefit design, formulary strategy, PBM operations, and pharmacy claims administration.

• Awareness of pharmacy financial drivers, trend analysis, forecasting inputs, and invoice reconciliation processes.

• Understanding of federal and state laws and regulations, along with applicable accreditation standards.

• Strong grasp of drug pipeline trends and factors influencing pharmacy costs and utilization.

• Excellent oral and written communication abilities.

• Must hold a pharmacy license for Maine and New Hampshire (or be eligible).

• 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.