Medicaid Plan Pharmacy Director

Health Care Service Corp.; Chicago (IL); Hybrid; USD 121,000 - 225,000; Full time

Job summary

Health Care Service Corporation seeks a senior pharmacy leader for a Medicaid health plan. You will drive pharmacy strategy, ensure regulatory compliance, and deliver strong financial and quality outcomes while aligning with enterprise clinical and pharmacy operations teams.

The role requires PharmD or equivalent, Illinois licensure, and 7+ years in managed care pharmacy, with strong analytical, communication, and data skills to manage complex regulatory requirements.

Qualifications

• PharmD or equivalent experience required.
• Active Illinois Pharmacist license.
• 7+ years experience in managed care pharmacy.
• Knowledge of medication use evaluation principles.
• Drug information skills.
• Analytical skills.
• Experience using Windows-based word processing, spreadsheet and relational database software.
• Verbal and written communications skills.
• Ability to remain at a work station and perform computer entry for long periods of time.
• Skills to handle multiple priorities and manage communications professionally to achieve issue resolution with customers, employees, or management.

Responsibilities

• Lead pharmacy strategy execution for a Medicaid health plan.
• Ensure regulatory compliance and financial performance including quality withhold/penalty programs.
• Collaborate with enterprise clinical and pharmacy operations teams to deploy strategy across the plan.

Skills

Medication use evaluation

Drug information skills

Analytical skills

Verbal and written communication

Computer literacy

Education

PharmD or equivalent experience

Licensed Pharmacist in Illinois

Tools

Relational databases

Windows-based Office tools

Job description

At HCSC, our employees are the cornerstone of our business and the foundation to our success. We empower employees with curated development plans that foster growth and promote rewarding, fulfilling careers. Join HCSC and be part of a purpose-driven company that will invest in your professional development.

Job Summary

This position serves as the senior pharmacy leader at an individual Medicaid health plan. They are accountable for pharmacy strategy execution, regulatory compliance, financial performance including quality withhold/penalty programs, member and provider experience and stakeholder engagement within the plan. This role operates within a matrixed enterprise model, partnering closely with enterprise clinical and pharmacy operations teams to ensure consistent strategy deployment while meeting state-specific Medicaid requirements.

JOB REQUIREMENTS

• Doctor of Pharmacy (PharmD) or equivalent experience.
• Registered Pharmacist in the state.
• 7+ years experience in managed care pharmacy.
• Knowledge of medication use evaluation principles.
• Drug information skills.
• Analytical skills.
• Experience using window based word processing, spreadsheet and relational database software.
• Verbal and written communications skills.
• Ability to remain at a work station and perform computer entry for long periods of time, as required.
• Skills to handle multiple priorities and manage communications professionally to achieve issue resolution with customers, employees, or management.

PREFERRED JOB REQUIREMENTS

• Experience in the managed Medicaid space.
• Strong financial and analytical acumen.

This is a Flex (Hybrid) role: requires 3 days in office; 2 days remote #LI-AC1 #LI-Hybrid

Pay Transparency Statement

At Health Care Service Corporation, you will be part of an organization committed to offering meaningful benefits to our employees to support their life outside of work.

From health and wellness benefits, 401(k) savings plan, pension plan, paid time off, paid parental leave, disability insurance, supplemental life insurance, employee assistance program, paid holidays, tuition reimbursement, plus other incentives, we offer a robust total rewards package for employees.

Learn more about our benefit offerings by visiting "https://careers.hcsc.com/totalrewards".

The compensation offered will vary depending on your job-related skills, education, knowledge, and experience. This role aligns with an annual incentive bonus plan subject to the terms and the conditions of the plan.

HCSC Employment Statement

We are an Equal Opportunity Employment employer dedicated to providing a welcoming environment where the unique differences of our employees are respected and valued. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, protected veteran status, or any other legally protected characteristics.

Base Pay Range $121,200.00 - $225,200.00 Exact compensation may vary based on skills, experience, and location.

For more than 80 years, HCSC has been dedicated to expanding access to high-quality, cost-effective health care and equipping our members with information and tools to make the best health care decisions for themselves and their families. As an industry leader, HCSC also has been helping to make the health care system work better for all Americans. To remain a leader, we offer compelling careers that encourage resourcefulness, strategic thought and empower you to make a difference in the lives of our members and their communities. Today, with the industry at an important crossroad, HCSC is reimagining health care and looking for original thinkers who aren’t afraid to make innovative contributions. We are an Equal Opportunity Employment employer dedicated to workforce diversity and a drug-free and smoke-free workplace. Learn more about HCSC, our commitment to our members and the opportunity you’ll have to improve health care delivery in an open, collaborative environment. HCSC is committed to diversity in the workplace and to providing equal opportunity to employees and applicants.