Director, Medicare Star Pharmacy Programs

Elevance Health (Anthem); Atlanta (GA); Hybrid; USD 140,000 - 200,000; Full time

Job summary

Elevance Health is seeking a Clinical Pharmacy Program Director to lead Medicare CMS Star initiatives and portfolio strategy. You will drive quality, cost of care improvements and enterprise performance across retail and medical benefits.

The role requires a PharmD with 5+ years in health plan managed care, including 3 years in leadership and 2 years of clinical experience, plus strong Excel and stakeholder management skills. Hybrid in-office work with geographic flexibility is expected.

Qualifications

• PharmD and current unrestricted license to practice pharmacy in applicable state(s).
• Minimum 5 years of health plan managed care experience including at least 3 years in management and 2 years of clinical experience.

Responsibilities

• Develops and implements Medicare CMS Star initiatives and procedures to improve quality, efficiency and cost of care.
• Serves as the subject matter expert for CMS Star program implementations.
• Establishes processes to monitor compliance and quality of care issues for CMS Star programs.
• Addresses and resolves program and Medicare contract performance to achieve target.
• Supports sales and account management for Elevance health plans.
• Builds effective relationships with internal and external stakeholders.
• Interfaces with claim and medical management systems experts to assist in early identification of high‑risk pharmacy claims.

Skills

CMS Star knowledge

Program management

Stakeholder management

Data analysis

Vendor management

Communication

Cross-functional collaboration

Education

PharmD

Tools

Excel

Job description

Elevance Health is seeking a Clinical Pharmacy Program Director to lead Medicare CMS Star initiatives and portfolio strategy. You will drive quality, cost of care improvements and enterprise performance across retail and medical benefits.

The role requires a PharmD with 5+ years in health plan managed care, including 3 years in leadership and 2 years of clinical experience, plus strong Excel and stakeholder management skills. Hybrid in-office work with geographic flexibility is expected.