Medicaid Pharmacy Strategy Director

Texas Health Institute; Seattle, Northern (WA, KY); Hybrid; USD 113,000 - 193,000; Full time

Job summary

UnitedHealthcare Community Plan of Washington is seeking a Plan Pharmacy Director to lead the pharmacy strategy and compliance for the health plan, including formulary and benefit coding. You will work with internal teams and external partners to align clinical initiatives with financial goals.

The role requires WA Pharmacist licensure, 3+ years in managed care pharmacy, and experience with Medicaid/Medicare plans.

Qualifications

• B.S.Pharm or Pharm.D and Washington license.
• 3+ years in Clinical Pharmacy, Sales, or Account Management.
• 3+ years in Managed Care Pharmacy (Health Plan or PBM).
• 1+ years Medicaid/Medicare plans experience.
• Experience presenting to senior management.
• Experience with pharmacy data and Utilization Review.
• Proficient in Word, Excel and PowerPoint.
• Excellent verbal and written communication skills.
• Strong time management and multitasking abilities.

Responsibilities

• Execute pharmacy benefit and compliance with contracts and regulations.
• Develop and drive strategic plans and goals for the plan.
• Provide strategic direction and financial impact analysis.
• Build strong relationships with internal and external partners.
• Assist on clinical program development and member satisfaction.
• Create and maintain state-specific policies.
• Serve as SME for formulary and prior authorization requirements.
• Communicate pharmacy program changes to plan departments.
• Engage with Medicaid/state meetings and stakeholders.
• Ensure timely submission of pharmacy reports and deliverables.

Skills

Pharmacy license

Clinical pharmacy

Medicaid/Medicare knowledge

Presentation skills

Data analysis (pharmacy)

Time management

Communication skills

Education

Pharmacist degree (BS.Pharm or Pharm.D)

Tools

Microsoft Office

Job description

UnitedHealthcare Community Plan of Washington is seeking a Plan Pharmacy Director to lead the pharmacy strategy and compliance for the health plan, including formulary and benefit coding. You will work with internal teams and external partners to align clinical initiatives with financial goals.

The role requires WA Pharmacist licensure, 3+ years in managed care pharmacy, and experience with Medicaid/Medicare plans.