Growth Strategy Director – Strategic Program Management
Humana
PMP
Staff Vice President, Specialty Pharmacy Clinical Operations
Elevance Health
full-time
Posted on:
Origin: • 🇺🇸 United States • California, Colorado, Illinois
Visit company websiteSalary
💰 $178,400 - $321,120 per year
Job Level
Lead
About the role
- Staff VP, Specialty Pharmacy Clinical Operations overseeing Clinical COE of BioPlus Specialty Pharmacy (including Kroger Specialty Pharmacy)
- Improve patient care outcomes, enhance service delivery, and ensure regulatory compliance
- Oversee functions including case management, prescription verification, care management, nursing, and clinical program development
- Manage specialty pharmacy management strategy across pharmacy and medical for the enterprise
- Participate in clinical program and policy development
- Manage Strategic Business Unit drug trend and drug spend per member per month (PMPM)
- Oversee development and maintenance of member/provider communications for safety and quality programs
- Establish drug benefit design strategies to ensure affordability, generic utilization, and medication adherence in compliance with laws and contracts
- Oversee cross-functional team of clinical, analytic, and pharmacy subject matter experts
- Provide regulatory/legislative expertise on pharmacy issues and support RFPs and client meetings
- Interface with Health Plan stakeholders, PBM leadership, and senior management
- Hire, train, coach, counsel, and evaluate direct reports
Requirements
- BA/BS and pharmacist license in applicable states
- Minimum of eight years of experience in a PBM clinical pharmacy
- Minimum of three years of management experience leading clinical professionals
- Or any combination of education and experience which would provide an equivalent background
- Proven track record of managing clinical operations
- Strong leadership and managerial skills with experience leading large, diverse teams
- Ability to inspire and motivate teams towards achieving key organizational objectives
- Understanding of clinical program development, case management, prescription verification, and patient care processes
- Experience in care management within a pharmacy setting
- Thorough understanding of industry regulations and compliance requirements relevant to specialty pharmacy
- Excellent communication and interpersonal skills
- Strong analytical and problem-solving skills
- Proven capability in driving continuous improvement initiatives and implementing innovative solutions
