[Hiring] Vice President of Pharmacy Services @Martin’s Point Health Care

Role Description

The Vice President of Pharmacy Services provides strategic leadership and oversight for all pharmacy operations within the organization and for all bid related formularies/strategies for market competitiveness and value. The Vice President is also responsible for the management of the PBM and other pharmacy related vendors as well as the Mail Order Pharmacy for USFHP.

The Vice President will be responsible for ensuring PBM contract compliance and rebate optimization, ensuring full CMS and USFHP compliance. They will also ensure optimal STARS and HEDIS performance with respect to Medication Adherence, analysis of population clinical data, and retail and specialty pharmacy spending for optimal clinical and fiscal management. This person will be a member of the Senior Leadership team and manage Medicare Advantage and USFHP pharmacy related programs, collaborating within the enterprise on pharmaceutical expense management, quality/utilization management and health plan/practice operations.

Qualifications

• BS Pharmacy or PharmD required
• PharmD, MBA preferred
• Must possess Maine and New Hampshire pharmacy license (or eligible)
• 10 years' experience including managed care experience (i.e., PBM, HMO, group practice) and retail pharmacy experience (i.e., chain, independent, mail order)
• Experience leading complex cross-functional projects and implementations
• Experience with pharmacy vendor management, contract oversight, and review of key contractual elements
• Experience supporting Medicare bid development, formulary strategy, or pharmacy financial analysis
• Experience evaluating pharmacy programs and policies from both clinical and financial perspectives
• Experience reviewing financial reports, reconciliations, invoices, and pharmacy trend data

Requirements

• Effective team leader/builder
• Excellent leadership qualities
• Mentor and coach
• Strategic thinker and problem solver with an eye for continual process improvement
• Strong knowledge of Medicare Part D regulations and the Medicare annual bid process
• Knowledge of pharmacy benefit design, formulary strategy, PBM operations, and pharmacy claims administration
• Knowledge of pharmacy financial drivers, trend analysis, forecasting inputs, and invoice reconciliation processes
• Knowledge of federal and state laws and regulations and applicable accreditation standards
• Ability to evaluate pharmacy policies and initiatives using both clinical and financial business judgment
• Strong understanding of drug pipeline trends and factors affecting pharmacy cost and utilization

Benefits

• Comprehensive benefits package including medical, dental, and vision
• Retirement savings with employer contributions
• Paid time off (including volunteer time off!)
• Pie day and other employee benefits

Company Description

Join Martin's Point Health Care - an innovative, not-for-profit health care organization offering care and coverage to the people of Maine and beyond. As a joined force of "people caring for people," Martin's Point employees are on a mission to transform our health care system while creating a healthier community. Martin's Point employees enjoy an organizational culture of trust and respect, where our values - taking care of ourselves and others, continuous learning, helping each other, and having fun - are brought to life every day. Join us and find out for yourself why Martin's Point has been certified as a "Great Place to Work" since 2015.