Pharmacist

Overview

• Lead the strategic management of Medicare Part D benefits to ensure clinical quality and regulatory compliance.
• Develop adherence programs and optimize medication access to improve Medicare Star Ratings.
• Oversee Pharmacy Benefit Manager (PBM) contracts to ensure performance targets and financial reporting accuracy.
• Address barriers to medication adherence, including cost, transportation, and health literacy challenges.
• Lead initiatives to enhance member satisfaction and optimize communication processes.
• Ensure timely handling of grievances and appeals in compliance with CMS standards.
• Collaborate with executive leadership to align pharmacy strategies with organizational goals.
• Mentor and develop high-performing teams to foster a culture of accountability and growth.

Key Responsibilities & Duties

• Design clinical interventions to improve adherence rates for key medication classes.
• Optimize medication supply strategies, including mail-order and auto-refill programs.
• Develop strategies to address barriers to medication use, enhancing access and literacy.
• Manage PBM contracts, ensuring compliance and performance targets are met.
• Lead efforts to improve member satisfaction with the drug plan.
• Oversee grievances and appeals processes to ensure compliance with CMS guidelines.
• Collaborate with cross-functional teams to align pharmacy operations with organizational goals.
• Provide expert guidance to executive leadership on pharmacy benefit strategies.

Job Requirements

• Bachelor's degree in Pharmacy or related field; advanced degree preferred.
• Minimum of 3-5 years of leadership experience in Medicare Part D benefit management.
• 5-7 years of progressive experience in managed care pharmacy or PBM settings.
• Proven ability to lead and mentor high-performing teams effectively.
• Strong knowledge of CMS guidelines and regulatory compliance requirements.
• Expertise in developing clinical programs to improve medication adherence.
• Experience in optimizing pharmacy operations and supply strategies.
• Excellent communication and collaboration skills with executive leadership.