Director of Product
ASAPP
Director, Pharmacy Quality and Part D Stars
Alignment Health
full-time
Posted on:
Origin: • 🇺🇸 United States
Visit company websiteSalary
💰 $149,882 - $224,823 per year
Job Level
Lead
About the role
- Create and implement a multi-year pharmacy Stars and quality roadmap, aligned with CMS methodology and enterprise Stars goals.
- Monitor CMS methodology updates, assess their impact on pharmacy measures, and integrate changes into Stars strategies and operations.
- Anticipate emerging trends and proactively adjust strategies to maintain and enhance pharmacy Stars performance.
- Lead the development and execution of pharmacy-driven strategies to improve Stars measures and quality outcomes, including medication safety, adherence, MTM, SUPD, SPC, and member experience.
- Monitor current performance and evaluate interventions, with added focus on areas of greatest opportunity or risk.
- Lead both internal pharmacy programs and PBM/vendor partnerships to ensure high performance and accountability across all Stars-related measures.
- Represent Pharmacy in PBM, vendor, and cross-functional forums, ensuring strategies are aligned and Stars performance expectations are achieved.
- Build and deliver dashboards, forecasts, and executive reports that translate complex data into actionable insights and recommendations, highlighting risks and guiding Stars performance decisions.
- Lead, mentor, and develop a high-performing team, fostering a culture of accountability, innovation, continuous improvement, and optimized workflows that support Stars performance.
Requirements
- 7+ years of experience in Medicare Part D, Stars, or pharmacy quality, including at least 5 years in leadership roles.
- Bachelor’s degree required; Advanced degree preferred (PharmD, RN, MPH, MBA, or related field).
- Demonstrated success improving CMS Star Ratings through pharmacy-driven initiatives and PBM/vendor collaboration.
- Deep knowledge of CMS Part D Stars methodology, pharmacy quality measures, and regulatory updates that impact performance.
- Expertise in leveraging data analytics to guide forecasting, strategy, and decision-making.
- Proven ability to lead teams, align cross-functional efforts, and communicate effectively with senior leadership.
- Proven ability to anticipate trends, adapt strategies, and deliver measurable improvements in Stars performance and member outcomes.
- Ability to communicate positively, professionally and effectively; provide leadership, teach and collaborate with others.
- Effective written and oral communication skills; ability to establish and maintain constructive relationships with diverse members, management, employees and vendors.
- Reasoning skills: prioritize multiple tasks; advanced problem-solving; use advanced reasoning to define problems, collect data, establish facts, draw valid conclusions, and design, implement and manage appropriate resolution.
- Problem-solving, organizational and time management skills; ability to work in a fast-paced environment.
