UNITE HERE HEALTH

Director of Pharmacy

UNITE HERE HEALTH

full-time

Posted on:

Location Type: Hybrid

Location: Las Vegas • Nevada • United States

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Salary

💰 $153,600 - $195,900 per year

Job Level

Lead

About the role

  • Manage Prescription Drug Programs: Oversee the development, negotiation, and implementation of pharmacy benefit management programs for health plans and employers.
  • Provides leadership and has accountability for the performance and results of The Culinary Health Fund’s PBM and retail pharmacies
  • Develops and monitors the pharmacy clinical policies and programs, where appropriate
  • Leads the development of innovative clinical solutions to help manage the cost of the Fund’s pharmacy benefits, including but not limited to medication therapy management services for high-risk and general populations
  • Leads the creation, maintenance, and enhancement of formularies for a variety of patient populations while working with lead clinicians and designated committees
  • Ensures the success of Pharmacy Utilization Management, Prior Authorization, and other controls for all managed populations
  • Negotiate Contracts: Work with pharmacies and pharmaceutical manufacturers to secure cost-effective medication options and manage rebate contracts.
  • Data Analysis: Analyze drug utilization data to inform formulary strategies and ensure appropriate medication use.
  • Analyzing pharmacy claims data to monitor drug spend and forecast trends
  • Develops, implements, and ensures continuous quality and process improvement to deliver effective and efficient programs and services
  • Regulatory Compliance: Ensure adherence to state and federal regulations regarding pharmacy benefits and prescription drug programs.
  • Develops, maintains, and oversees local, state, and national regulatory compliance for all PBM services
  • Provides oversight to ensure successful outcome of compliance audits/reviews (e.g., URAC)
  • Relationship Management: Maintain relationships with pharmacies, healthcare providers, and other stakeholders to facilitate effective communication and service delivery.
  • Collaborates with the Fund’s departments, Regional Directors and external stakeholders on service delivery including development and implementation of a network of community pharmacies to support broader healthcare delivery programs and to resolve claim issues
  • Accountable for the performance of the various vendors engaged by the PBM for Pharmacy programs, analytical services and resolves issues affecting the service or financial objectives of the PBM
  • Facilitates communication with network pharmacies
  • Cost Management: Identifying cost-saving opportunities and developing strategies to reduce expenses.
  • Provides leadership oversight for the assessment of value-based pharmacy programs to continually enhance the pharmacy programs

Requirements

  • 5 ~ 7+ years of direct experience
  • Working knowledge and experience in PBM contracts, benefit programs, funding arrangements, administrative arrangements, insurance products, compliance, etc.
  • Strong pharmaceutical knowledge including clinical aspects and formulary development
  • Knowledge of a wide-range of patient-centered and pharmacy management programs
  • Bachelor's degree in pharmacy or related field or equivalent work experience required
  • Doctor of Pharmacy (PharmD), preferred
  • Completion of PBM (Pharmacy Benefit Manager) residency (minimum 1 year)
  • Required: License in Pharmacy in good standing in the state of Nevada
  • The ability to travel 15% ~ 25% as needed by the business
Benefits
  • Medical
  • Dental
  • Vision
  • Paid Time-Off (PTO)
  • Paid Holidays
  • 401(k)
  • Short- & Long-term Disability
  • Life
  • AD&D
  • Flexible Spending Accounts (healthcare & dependent care)
  • Tuition Assistance
  • Employee Assistance Program (EAP)
Applicant Tracking System Keywords

Tip: use these terms in your resume and cover letter to boost ATS matches.

Hard Skills & Tools
pharmacy benefit managementformulary developmentmedication therapy managementdata analysiscost managementregulatory compliancequality improvementcontract negotiationpharmacy claims analysisclinical policy development
Soft Skills
leadershiprelationship managementcommunicationcollaborationaccountabilityproblem-solvingstrategic thinkingorganizational skillsstakeholder engagementperformance management
Certifications
Doctor of Pharmacy (PharmD)License in Pharmacy in good standing in NevadaPBM residency completion