Remote Plan Pharmacy Director: Medicaid & PBM Strategy

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

Benefits offered by this job

Comprehensive benefits package

Equity stock purchase plan

401k contribution

Job summary

UnitedHealthcare is seeking a Plan Pharmacy Director for the Washington Community Plan to lead pharmacy strategy, PY/PDL implementation, and state policy alignment. This role directs pharmacy programs, engages external stakeholders, and ensures compliance with Medicaid regulations.

You will collaborate with Medicaid and health plan teams to optimize affordability, reporting, and clinical initiatives while guiding pharmacy services across the plan.

Qualifications

• B.S.Pharm or Pharm.D is required.
• Current, unrestricted Washington Pharmacist license.
• 3+ years in Clinical Pharmacy, Sales, or Account Management.
• 3+ years in Managed Care Pharmacy within a Health Plan or PBM.
• 1+ year of Medicaid/Medicare plan experience.
• Experience engaging senior management in presenting to groups.
• Experience with pharmacy data and Utilization Review.
• Proficient in Word, Excel, PowerPoint.

Responsibilities

• Execute pharmacy benefit and compliance with state contracts, policies, and regs.
• Develop and drive strategic plans leveraging managed care and PBM knowledge.
• Analyze forecasting and trend information for planning.
• Provide strategic direction and financial impact analysis for pharmacy priorities.
• Build strong relationships with internal/external partners as primary Pharmacy contact.
• Support clinical program development and member satisfaction.
• Communicate policy changes to health plans' departments.
• Lead dissemination of formulary, prior authorization, and benefit coding requirements.

Skills

Clinical Pharmacy

Managed Care Pharmacy

Medicaid/Medicare plans experience

Verbal and written communication

Time management

Organizational skills

Presentation skills

Pharmacy data analytics

Education

B.S.Pharm or Pharm.D

Tools

Microsoft Office Suite

Job description

UnitedHealthcare is seeking a Plan Pharmacy Director for the Washington Community Plan to lead pharmacy strategy, PY/PDL implementation, and state policy alignment. This role directs pharmacy programs, engages external stakeholders, and ensures compliance with Medicaid regulations.

You will collaborate with Medicaid and health plan teams to optimize affordability, reporting, and clinical initiatives while guiding pharmacy services across the plan.