Senior Director of Pharmacy

Job Ref: TE0143
Category: Professional
Department: PHARMACY
Location: 50 Water Street, 7th Floor, New York, NY 10004
Job Type: Regular
Employment Type: Full-Time
Work Arrangement: Hybrid
Salary Range: $250,000.00 - $265,927.00

Position Overview:

Empower. Unite. Care.

MetroPlusHealth is committed to empowering New Yorkers by uniting communities through care. We believe that Health care is right, not a privilege. If you have compassion and collaborative spirit, work with us. You can come to work being proud of what you do every day.

The Senior Director of Pharmacy is a senior level leader providing oversight, direction and decision-making for Pharmacy programs across the entire managed care plan and ensuring that Pharmacy achieves performance excellence in terms of quality, safety, service, affordability and technology. This is an exciting opportunity for a self-starter who wants to enhance the current pharmacy program/function for the organization. This position is responsible for the development, execution, and updating of a Pharmacy strategy that addresses all current lines of business of the organization (Medicare Part D, Commercial, and Medicaid). The strategy will ensure pharmacy addresses external threats and opportunities. The Senior Director of Pharmacy is also responsible for establishing strong collaborative relationships with external pharmacy leaders in various healthcare systems and organizations.

This position is expected to understand and assess the external healthcare and pharmacy environment and to develop short-term and long-term plans to ensure that MetroPlusHealth is well-positioned within the current and future landscape. This position provides leadership and oversight for the design, implementation, and ongoing administration of prescription drug benefits including, Medicare Part D. The Senior Director of Pharmacy is expected to leverage MetroPlusHealth’s integrated model of health care delivery to engage with Physicians and other health care leaders to further integrate pharmacy services into the care delivery and chronic disease management to achieve system wide improvements in member care outcomes. This position engages with senior leaders and key stakeholders to ensure the optimal utilization of technology and resources, to support the implementation of enterprise-wide pharmacy systems and processes, including large-scale operational projects.

Scope of Role & Responsibilities:

• Lead and direct the development and execution of strategies and programs for delivering pharmacy services across the plan in order to achieve high quality, affordable health care that improves our members’ lives.
• Chair Pharmacy & Therapeutics (P&T) Committee and associated committees.
• Assess external pharmacy industry trends and developments that represent risk and opportunities for the organization.
• Develop short and long-term initiatives to respond to potential risks and to capitalize on opportunities.
• Lead the monitoring and oversight of the contracted PBM for all managed lines of business
• Analyze key metric reports and make recommendations as necessary.
• Create workplans to drive efficiencies in pharmacy operations.
• Develop and lead MetroPlusHealth’s pharmacy quality initiatives as required.
• Develop and lead internal Utilization Management processes of medications.
• Lead maintenance and implementation of all Medicare Part D Operations for the organization.
• Develop and implement pharmacy case management for MetroPlusHealth’s members
• Configure pharmacy benefit design across all lines of business
• Negotiate and manage contracts with Pharmacy Related Vendors across all lines of business, including PBMs, consultants and resources
• Develop and lead Fraud Waste and Abuse monitoring protocols for pharmacy items
• Lead the development and management of the MetroPlusHealth formularies including alignment with high volume facilities.
• Manage the NYS Restricted Recipient Program
• Act as a clinical resource for all MetroPlusHealth’s departments as required.
• Represent MetroPlusHealth at community, governmental and professional events.
• Maintain regulatory compliance according to New York State and Federal regulations.

Required Education, Training & Professional Experience:  

• Doctor of Pharmacy required
• Clinical pharmacy experience in a managed care environment required
• Minimum of eight (8) years of senior leadership-level experience and documented record of success in management of a multi-disciplinary pharmacy operations, required.
• Experience in a clinical pharmacy leadership role in managed care, including government programs (Medicare, Medicare Part D, and Medicaid) lines of business or prior experience in formulary management at the integrated health system level, prior hospital pharmacy experience, ambulatory care pharmacy experience, and clinical pharmacy practice.
• Prior experience completing evidenced based formulary reviews, supportive literature evaluation, development of clinical pharmacy programs, presenting clinical information to providers and committees are required.
• Extensive clinical knowledge of medical and pharmacy practice issues is required.
• Knowledge of managed care strategies, drug benefit management strategies for pharmacy, hospital and medical group experience is preferred.
• Advanced education or equivalent experience in pharmaceutical outcomes measurement, cost/benefit analysis, value based clinical decision making is preferred.
• Position requires excellent organizational, teamwork, interpersonal, time management, written and verbal communication skills.
• Position requires the capability to set priorities amongst a series of competing clinical and operational priorities and to effectively direct the work of others.
• Proficiency with MS Word, Excel, and PowerPoint is required. Experience in the evaluation and interpretation of pharmacy claims data and other clinical data is preferred.

Licensure and/or Certification Required:

• Valid license and current registration to practice as a Pharmacist issued by the New York State Education Department (NYSED).

Professional Competencies:

• Integrity and Trust
• Customer Focus
• Functional/Technical skills
• Written/Oral Communication

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