Director - Pharmacy

Astrana Health Management; Monterey Park (CA); Hybrid; USD 175,000 - 225,000; Full time

Job summary

Astrana Health Management seeks a working Director of Pharmacy to stand up a formal pharmacy function focused on drug utilization management and cost-of-care strategy. This leader will set the pharmacy strategy and run complex reviews while building the program from the ground up inside a fast-growing, physician-led organization.

The role is hybrid, based in Monterey Park, CA, with a strong emphasis on collaboration with medical directors and cross-functional teams to optimize care and costs

Qualifications

• 5+ years of experience in managed care pharmacy, PBM, or health plan utilization management.
• Experience leading cost-of-care initiatives such as biosimilar conversion or specialty pharmacy contracting.
• Strong analytical skills and ability to build ROI models for pharmacy programs.

Responsibilities

• Lead and build out the pharmacy function as the organization’s first dedicated pharmacy leader for drug utilization management and clinical strategy.
• Own end-to-end utilization management for provider-administered and specialty drugs, including prior authorization review and appeals.
• Design and lead cost-of-care initiatives across biosimilar conversion, site-of-care optimization, and dose optimization.
• Develop and manage specialty pharmacy contracting strategy and direct appropriate volume to internal channels.
• Partner with medical directors, care management, and network teams to build clinical pathways and formulary/UM criteria.
• Build and maintain reporting dashboards tracking drug spend trends and UM turnaround-time performance.
• Collaborate with Health Services, Network Management, Finance, and Compliance to align pharmacy strategy.
• Monitor CMS, state Medicaid, and payer formularies to ensure compliance.
• Establish policies and workflows for the pharmacy function and plan for team growth.

Skills

Pharmacy leadership

Utilization management

Cost-of-care optimization

Cross-functional collaboration

Data analytics

Education

Doctor of Pharmacy (PharmD)

Job description

Director - Pharmacy

Department: Pharmacy

Employment Type: Full Time

Location: 1600 Corporate Center Dr., Monterey Park, CA 91754

Reporting To: George Christidies

Compensation: $175,000 - $225,000 total compensation

Description

Astrana Health is a physician-centric, technology-enabled healthcare company built to deliver accessible, high-quality, high-value care. As our value-based membership has grown, so has the complexity and cost of specialty and drug-related utilization. This is a newly created, high-visibility role: Astrana's first dedicated pharmacy leader on the health plan/payer side, responsible for standing up a formal pharmacy function to manage drug utilization management (UM) and lead cost-of-care strategy across our specialty and provider-administered drug spend.

This is a working director role. You will set pharmacy strategy and build the function, while also rolling up your sleeves on complex utilization management reviews and cost initiatives in the near term. It's an opportunity to build a pharmacy program from the ground up inside a fast-growing, physician-led organization and to directly influence patient outcomes and cost of care at scale.

What You'll Do

• Lead and build out Astrana's pharmacy function, serving as the organization's first dedicated pharmacy leader for drug-related utilization management and clinical pharmacy strategy.
• Own end-to-end utilization management for provider-administered (J-code) and specialty drugs, including prior authorization review, clinical criteria, and appeals, while personally handling complex case reviews as a working director.
• Design and lead cost-of-care initiatives across biosimilar conversion, site-of-care optimization, dose optimization, white labeling, and Buy-and-Bill-to-Part D (B to D) conversion.
• Develop and manage specialty pharmacy contracting strategy, and direct appropriate volume to Astrana's own specialty pharmacy channel where clinically and financially appropriate.
• Partner with medical directors, care management, and network teams to build clinical pathways and formulary/UM criteria for high-cost specialty and infusion therapies.
• Build and maintain reporting and dashboards that track drug spend trends, savings initiatives, and UM turnaround-time performance for leadership.
• Collaborate cross-functionally with Health Services, Network Management, Finance, and Compliance to align pharmacy strategy with broader organizational goals.
• Monitor the regulatory and payer landscape (CMS, state Medicaid, health plan formularies) affecting specialty drug and UM requirements, and ensure programs remain compliant.
• Establish policies, workflows, and documentation standards for the pharmacy function, and help scope and build out the team as volume and scope grow.

Qualifications

• Doctor of Pharmacy (PharmD) required, with an active, unrestricted pharmacist license (California license required or willingness to obtain promptly).
• 5+ years of experience in managed care pharmacy, PBM, or health plan utilization management, including direct experience managing J-code/provider-administered specialty drug review.
• Demonstrated track record leading cost-of-care pharmacy initiatives such as biosimilar conversion, site-of-care optimization, or specialty pharmacy contracting.
• Hands-on experience with utilization management workflows, prior authorization criteria design, and P&T (Pharmacy & Therapeutics)-type governance processes.
• Strong analytical skills, with the ability to build and track savings and ROI models for pharmacy programs.
• Comfortable operating as a working leader, balancing strategic program-building with hands-on case review and day-to-day execution.
• Excellent cross-functional communication skills and experience partnering with medical directors, network, finance, and compliance teams.
• Experience in a value-based care organization, IPA, MSO, or health plan strongly preferred.
• Board certification (e.g., BCPS, BCACP) a plus.

Environmental Job Requirements and Working Conditions

• Our organization follows a hybrid work structure where the expectation is to work both in office and at home on a weekly basis. The office is located at 1600 Corporate Center Dr. Monterey Park, CA 91754.
• The national target pay range for this role is $175,000 - $225,000 total compensation including base, bonus, and equity (RSUs). Actual compensation will be determined based on geographic location (current or future), experience, and other job-related factors.