[Hiring] Director, Clinical Pharmacy Stars Performance @Devoted Health

Role Description

As Director, Clinical Pharmacy Stars Performance, you are the tactical owner of every clinical pharmacy-related measure in our Medicare Advantage and Part D Star Ratings portfolio. Your job is to drive our clinical pharmacy Stars enterprise strategy into daily reality, measure by measure, member by member, week by week.

You will be the enterprise clinical subject matter expert on pharmacy quality:

• The person Medical Directors call before they call anyone else.
• The person who reads the Technical Notes the day they drop.
• The person who can tell us in February where a cut point is going to land in October and what we need to do about it now.

You will also be the person building the tracker, setting the objectives and key results, and personally auditing whether the outreach was actually effective. You will report directly to the AVP, Pharmacy, carrying the portfolio into executive meetings, leading cross-functional escalations, and owning outcomes.

Responsibilities and Impact

• Performance Management & Insight Generation: Own the performance trajectory of the full clinical pharmacy Star portfolio, including:
  • Triple-weighted medication adherence measures (Diabetes, RAS Antagonists, Statins)
  • Statin Use in Persons with Diabetes (SUPD)
  • Polypharmacy: Use of Multiple Anticholinergic Medications in Older Adults (Poly-ACH)
  • Concurrent Use of Opioids and Benzodiazepines (COB)
  Forecast measure trajectories against projected cut points, identify risk months before it shows up in a year-end score, and translate the analysis into daily, weekly, and monthly operating directives that internal teams and vendors can execute against.
• Clinical Subject Matter Expertise & Clinical Collaboration: Serve as the authoritative clinical voice on pharmacy quality. Track regulatory specification changes and clinical guideline shifts and interpret what they mean for our operations. Lead peer-to-peer dialogue with clinical leaders within Devoted and our growing provider network.
• Future Measure Readiness: Keep us ahead of the measure set rather than reacting to it. Track what CMS is developing, what sits on the display page, and what the measure developer pipeline is producing. Build the data and operational capability for a measure while it's still on display.
• Strategy & Innovation: Design organization-wide strategies across the portfolio of clinical pharmacy measures to deliver 5-Star performance at scale. Identify innovative opportunities to eliminate friction points along members’ healthcare journeys.
• Excellent Cross-Functional Execution: Manage performance against operating KPIs and clinical outcomes metrics by partnering with internal Devoted teams and external partners, including our PBM.
• Market Awareness: Keep a pulse on the vendor landscape regarding adherence stratification, pharmacist-led intervention, and pharmacy network engagement.
• Servant Leadership: Drive execution through a blend of direct management and leadership through influence, operating with a true servant-leader mindset.

Qualifications

• PharmD or equivalent clinical degree.
• 7+ years of progressive leadership in managed care, a health plan, or a PBM.
• Demonstrated leadership impact and collaborative excellence.
• Clinical diplomacy.

Requirements

• Execution instinct: A relentless self-starter who refuses to let initiatives die in committee.
• Insight generation: Advanced analytical acumen and the ability to see past the surface of a dashboard.

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.
• Bonus eligibility for all roles excluding Director and above; Commission eligibility for Sales roles.
• Parental leave program.
• 401K program.
• And more...