Medicaid Plan Pharmacy Director

hcsc; Chicago (IL); Hybrid; USD 121,000 - 225,000; Full time

Job summary

Health Care Service Corporation in Chicago, IL is seeking a senior pharmacy leader for a Medicaid health plan to drive pharmacy strategy and regulatory compliance across the plan. You will oversee financial performance, quality withhold/penalty programs, and member/provider experience while engaging stakeholders.

In this hybrid role, expect collaboration with enterprise clinical and pharmacy operations teams to deploy strategy and ensure state Medicaid requirements are met, with focus on

Qualifications

• PharmD or equivalent; licensed pharmacist in IL.
• 7+ years of experience in managed care pharmacy.
• Knowledge of medication use evaluation and drug information.

Responsibilities

• Lead pharmacy strategy execution and regulatory compliance for a Medicaid health plan.
• Oversee financial performance including quality withhold/penalty programs.
• Improve member and provider experience while engaging stakeholders.
• Collaborate with enterprise clinical and pharmacy operations teams to deploy strategy.

Skills

Analytical skills

Communication skills

Drug information skills

MUE principles

Managed care pharmacy

Education

PharmD

Pharmacist license

Tools

Word processing

Spreadsheet

Relational databases

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

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.