Lumeris

Director

• Serve as a Part D Stars subject matter expert - provide clinical guidance and recommendations to enhance member outcomes, medication adherence, and overall health plan performance related to Part D Star measures
• Develop, recommend and implement Part D Stars operational strategy and roadmap
• Analyze, interpret, and enhance Part D Stars data and other pharmacy utilization reporting to identify areas for improvement and develop action plans to drive performance improvement
• Develop provider focused education and best practice content to be used in external partner meetings that drive improvement in Part D Stars and pharmacotherapy utilization optimization which supports safe and effective medication use
• Collaborate with cross-functional teams, including but not limited to provider services, quality, data analytics, pharmacy operations to ensure alignment and execution of Part D Star improvement initiatives
• Participate in oversight of Part D Stars vendors and identify new partnership opportunities
• Clearly articulate progress, achievements, and opportunities related to Part D Star measures to key stakeholders
• Assists in the development and review of pharmacy utilization reports targeted at physician group level and physician-specific level. Makes recommendations on ways to optimize pharmacotherapy utilization
• Trains pharmacy team members and other internal stake holders on Part D Star measures, initiatives, best practices and how to leverage target reporting to engage provider group partners.
• Guides and mentors team members to achieve departmental and company goals
• Collaborate closely with the VP, Clinical Pharmacy and Director, Pharmacy Operations to oversee and execute all pharmacy operations pertinent to Part D Stars and pharmacy benefit optimization
• Stay abreast of industry trends, regulatory changes, and best practices related to Part D Star measures and quality improvement
• Performs special projects as assigned

Clinical Pharmacy Director, Part D Stars

Compliance

• Shape the Compliance Future: Architect, implement, and evolve compliance programs across innovative care models and provider relationships.
• Be the Regulatory Authority: Act as the expert for all things provider compliance—guiding stakeholders through gray areas, interpreting regulations, translating dense rules into practical direction, and driving consensus across clinical, legal, and operational teams.
• Lead and Influence: Work shoulder-to-shoulder with senior leaders and clients as a trusted strategic advisor, bringing actionable insights and regulatory clarity to new partnerships, programs, and high-impact initiatives.
• Educate and Empower: Develop engaging training programs and resources that equip teams and partners at every level with the knowledge to navigate compliance and champion a culture of integrity.
• Drive Continuous Improvement: Proactively scan the regulatory horizon for emerging risks, keeping us a step ahead on evolving requirements, and embed robust processes to sustain excellence and transparency.
• Be a Culture Carrier: Forge an organization-wide appreciation for compliance and ethical practice; you’ll be a visible leader who models honesty, transparency, and a continuous-improvement mindset.

Clinical Pharmacy Director, Part D Stars

Provider and Practitioner Compliance Director