CLINICAL PROGRAMS VICEPRESIDENT - PHARMACY

Temporary Professional Integrated Services; San Juan (PR); On-site; USD 135,000 - 165,000; Full time

Benefits offered by this job

Comprehensive benefits package

Job summary

JobRx, Inc. seeks a visionary Vice President in managed care pharmacy to lead the Pharmacy Department for a health insurance client. This role oversees clinical programs to ensure regulatory compliance and achieves population health goals.

The ideal candidate holds a PharmD and has extensive experience in pharmacy program development. Competitive salary starts at $150,000+, complemented by a comprehensive benefits package.

Qualifications

• 9 years of progressive leadership experience in managed care pharmacy.
• 4 years of direct supervisory experience required.
• Proven success applying quality and performance metrics.

Responsibilities

• Develop and lead work plans for Clinical Services and Pharmacy Utilization.
• Oversee delegated provider functions related to clinical programs.
• Ensure compliance with CMS, NCQA, HEDIS, and STARS regulations.

Skills

Leadership in Managed Care Pharmacy

Clinical Program Development

Pharmacy Quality Management

Pharmacy Benefit Systems

Clinical Data Analytics

Education

Doctor of Pharmacy (PharmD)

Job description

OVERVIEW

We are seeking a visionary leader in managed care pharmacy to drive the strategic design, execution, and oversight of all clinical and quality programs within the Pharmacy Department of our renowned health insurance client company. This executive role shapes the organization's pharmacy clinical strategy, ensuring alignment with regulatory requirements, population health goals, and enterprise-wide objectives.

The VP serves as the enterprise pharmacy clinical expert, overseeing high‑impact programs such as MTM, Drug Management Programs, CMS STARS initiatives, pharmacy utilization strategies, academic education, member education programs, and regulatory management of grievances and appeals. This role also leads the Pharmacy Account Management function, strengthens cross‑functional collaboration, and represents the department in executive, regulatory, and client‑facing forums.

KEY RESPONSIBILITIES

• Develop and lead comprehensive work plans for Clinical Services, Pharmacy Utilization, and Account Management, ensuring full compliance with federal and local regulations.
• Direct the design, implementation, and continuous improvement of pharmacy clinical programs aligned with organizational goals, quality standards, and member needs.
• Oversee delegated provider functions related to MTMP, Integrated Diabetes Programs, Specialty Pharmacy Interventions, DMP/DPP, and STARS measures.
• Ensure all clinical and quality programs meet CMS, NCQA, HEDIS, STARS, and other applicable regulatory requirements.
• Serve as the primary clinical liaison between Pharmacy and Clinical Affairs, ensuring seamless integration of pharmacy services into broader clinical initiatives.
• Lead the Pharmacy Account Management team, ensuring exceptional client support, operational efficiency, and alignment with business strategy.
• Oversee all pharmacy communications, including member‑facing materials and regulatory documents, ensuring accuracy, timeliness, and brand compliance.
• Represent the Pharmacy Department in client meetings, regulatory interactions, and internal executive forums, delivering strategic presentations and guidance.
• Contribute to departmental budgeting and ensure all clinical and quality initiatives are executed within budget while maintaining operational excellence.

CANDIDATE'S PROFILE

Education & Experience

• Doctor of Pharmacy (PharmD) or equivalent degree required.
• Minimum 9 years of progressive leadership experience in managed care pharmacy, clinical program development, or pharmacy quality management.
• At least 4 years of direct supervisory experience.
• Proven success applying quality and performance metrics.

Certifications / Licensure

• Active pharmacist license and registration in Puerto Rico.
• Membership in the Puerto Rico Pharmacists Association.

Technical Knowledge

• Deep expertise in CMS, NCQA, HEDIS, STARS, and federal/state health regulations.
• Strong command of pharmacy benefit systems, clinical data analytics, and population health strategies.

Languages

• Spanish - Advanced
• English - Advanced

Compensation

• Annual Salary starting at $150,000+
• Comprehensive benefits package

TPIS is an Equal Opportunity Employer (EEO Employer / Affinitive Action for Females / Disabled / Veterans). We comply with all Federal, State and Local laws regarding nondiscrimination.