Director of Pharmacy - Aspire Health (Remote)

Montage Health; California (MO); Remote; USD 120,000 - 150,000; Full time

Job summary

Montage Health is seeking a Director of Pharmacy Services to oversee pharmacy strategy, operations, and cost management. This role involves collaborating with senior leadership and ensuring compliance with regulations while enhancing community health through pharmacy interventions.

Qualifications

• Minimum of five years in senior managerial roles within the pharmaceutical industry.
• Experience in insurance pharmacy management and managing pharmacy functions in Medicare and/or Medicaid health plans.

Responsibilities

• Establish overall strategy and tactics for pharmaceutical services.
• Manage pharmacy trend, cost, and utilization across all business lines.
• Conduct audits and produce reports to evidence quality pharmacy services.

Skills

Negotiation

Customer Focus

Emotional Intelligence

Education

Doctor of Pharmacy

Job description

Welcome to Montage Health’s application process!

Job Description:

Position Overview: The Director of Pharmacy Services is accountable for all aspects of pharmacy strategy, tactics, and clinical operations for Aspire Health, including pharmacy-related partners and delegated organizations. This role involves setting the strategic vision for Pharmacy Services within all Health Services functions, providing education, training, and direction to pharmacy staff and health plan departments, and collaborating with senior leadership to achieve corporate and Pharmacy Services goals. Key focus areas include managing pharmacy costs across all lines of business, benefit design, formulary development, contract negotiation, clinical vendor oversight, expanding clinical pharmacy services, provider collaboration, and member education. The director is chiefly responsible for managing pharmacy costs, improving pharmacy-related quality performance (such as STARs and other quality metrics), reducing operating costs, and enhancing community health through pharmacy interventions, all while ensuring compliance with applicable regulations and policies.

Essential Responsibilities:

1. Establish overall strategy and tactics for pharmaceutical services across all lines of business in all geographies, in collaboration with the Senior Leadership Team.
2. Manage pharmacy trend, cost, and utilization across all business lines.
3. Ensure pharmacy benefit management capabilities are competitive and support growth.
4. Oversee clinical aspects of PBM and contracted entities supporting pharmacy functions.
5. Participate in strategic and internal committees to disseminate information and represent company philosophy.
6. Oversee delegated P&T Committee and report actions to Quality Improvement & Utilization Management Committee.
7. Collaborate with providers and health plan partners to optimize generic and lower-cost alternatives, ensuring formulary adherence.
8. Manage hiring, staff development, performance reviews, and corrective actions within the Pharmacy Services department.
9. Develop and monitor actionable reporting with Business Intelligence and HIT teams to oversee pharmacy functions.
10. Conduct audits and produce reports to evidence quality pharmacy services and meet Medicare requirements.
11. Define, implement, and manage pharmacy programs, including medication therapy and drug utilization management.
12. Coordinate with quality teams to improve STARs measures and medication reconciliation.
13. Develop and monitor annual budgets for the department.
14. Ensure compliance with contracts, state, and federal regulations.
15. Establish programs to promote positive relationships with providers and organizations.
16. Provide feedback and analysis on regulations impacting pharmacy and operations.
17. Respond to pharmacy-related inquiries supporting membership growth and retention.
18. Perform all functions in accordance with policies, procedures, and professional standards, ensuring excellent customer service and confidentiality.

Work Experience: Minimum of five years in senior managerial roles within the pharmaceutical industry, with experience in insurance pharmacy management, strategic direction, and managing pharmacy functions in Medicare and/or Medicaid health plans.

Education, Certificates, Licenses: Unrestricted license to practice pharmacy in California and a Doctor of Pharmacy degree.

Knowledge: Extensive knowledge of healthcare business principles, strategic and operational planning, healthcare economics, personnel administration, federal laws, financial analysis, industry trends, delivery system transformation, and pharmaceutical treatment. Proactive in adopting new pharmacy systems and procedures, with strong negotiation skills and familiarity with local pharmacy practices.

Competencies:

• Authenticity
• Building Organizational Talent
• Coaching and Developing Others
• Cultivating Networks
• Customer Focus
• Empowerment/Delegation
• Emotional Intelligence
• Establishing Strategic Direction
• Leading Change
• Optimizing Diversity
• Passion for Results

Environment: Office setting with ergonomic equipment; approximately 30% local travel required.

Physical Requirements: Ability to sit, stand, stoop, bend, perform repetitive motions, lift light materials, and communicate effectively in English.

Equal Opportunity Employer

#LI-AC1

Assigned Work Hours: Full-time (exempt)

Position Type: Regular