VP, Pharmacy Clinical & Quality Programs

MCS Puerto Rico; San Juan (PR); On-site; USD 140,000 - 200,000; Full time

Job summary

MCS Puerto Rico is seeking a senior leader to oversee the implementation, administration, and continuous improvement of clinical and quality pharmacy programs within the Pharmacy Department. The role manages MTM, DMP, CMS STARS initiatives, utilization programs, and member education, while coordinating regulatory grievances and appeals.

The position drives program performance, vendor collaboration, and integration with population health initiatives, reporting to pharmacy leadership and

Qualifications

• Doctor of Pharmacy (PharmD) or equivalent required.
• 8+ years of progressive leadership in managed care pharmacy or quality management.
• 5+ years supervising personnel.
• In-depth CMS, NCQA, HEDIS, STARS knowledge.

Responsibilities

• Oversee clinical services, utilization, and account management programs to ensure regulatory compliance.
• Develop and enhance clinical pharmacy programs aligned with quality standards and member needs.
• Monitor CMS STARS measures and vendor activities for performance and regulatory compliance.
• Coordinate CMS/NCQA regulatory requirements and identify improvement opportunities.
• Lead cross-functional collaboration to integrate pharmacy programs with care management and population health.

Skills

Leadership

Regulatory knowledge

CMS STARS familiarity

Population health strategy

Education

Doctor of Pharmacy (PharmD)

Tools

PBM systems

Clinical data analytics

Job description

MCS Puerto Rico is seeking a senior leader to oversee the implementation, administration, and continuous improvement of clinical and quality pharmacy programs within the Pharmacy Department. The role manages MTM, DMP, CMS STARS initiatives, utilization programs, and member education, while coordinating regulatory grievances and appeals.

The position drives program performance, vendor collaboration, and integration with population health initiatives, reporting to pharmacy leadership and