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Under the direction of the Chief Pharmacy Officer, the Clinical Pharmacy Director is responsible for managing a team focused on developing and executing comprehensive clinical pharmaceutical strategies that focus on improving health outcomes and affordability while delivering an unparalleled consumer experience for members, accounts and providers. Responsibilities include developing clinical programs and partnering with internal and external partners on optimal use and management of pharmaceuticals across the pharmacy and medical benefits. This position requires strong business acumen and ability to navigate cross functional relationships at all levels of the organization.

Major Responsibilities:

• Lead ongoing implementation and maintenance of clinically appropriate and cost-effective programs to help control the escalating costs of pharmaceuticals and utilization across all lines of business including but not limited to formulary and utilization management strategies, benefit coding, website updates, member and provider communications, and internal training
• Develop clinical programs directed at providers, customers, and internal care/case management teams in support of drug driven strategies to lower total cost of care.
• Evaluate programs after implementation to ensure corporate objectives are met and identify areas of simplification for consumers
• Oversee clinical and analytical evaluation of medication pipeline, supporting clinical policy development and management strategies
• Facilitate Pharmacy and Therapeutics committee review and new to market medication evaluation processes
• Partner with key external pharmacy organizations and develop aligned infrastructure to help facilitate success of clinical programs
• Collaborate within the organization to support quality initiatives and other related activities related to HEDIS and NCQA
• Maintain all departmental policies and procedures related to drug management processes
• Assist in ensuring pharmacy related processes are carried out in accordance with DOI, CMS, and other federal and state requirements and guidance, including executive orders, regulatory requirements, and administrative rules. ·
• Develop and implement programs with internal departments, the PBM, and/or other vendors to improve the member and provider experiences, including efforts toward population health and quality initiatives
• Make presentations to and develop training, reports, and other communications for internal associates, members, providers, and other stakeholders related to pharmacy management results and trends
• Lead team of clinical pharmacists to execute strategic plan and hold individuals accountable for meeting deliverables and outcomes
• Special projects as assigned

Qualifications:  (Knowledge, skills and abilities)

• Ability to effectively manage, motivate, coach and mentor clinical staff to foster accountability and ownership of projects and deliverables
• Demonstrated ability to deliver results
• Ability to shape and execute strategy
• Proven capabilities in strategic planning and large-scale project management
• Demonstrated ability to think/act strategically from a program value perspective and influence key leaders and matrix partners
• Strong leadership, relationship building and influencing skills
• Strong organizational and time management skills, including ability to work independently and prioritize multiple projects and assignments
• Demonstrated strength in analysis, identification of problems and issue resolution
• Strong written/verbal communication skills including presentation skills
• Strong proficiency in MS Outlook, Word, Excel, PowerPoint, Visio, and Access

Education/Relevant Experience:

• Professional Registered MA Pharmacist.  Must hold unrestricted, current, and valid license to practice Pharmacy in the state of Massachusetts
• Post-graduate residency / fellowship program or equivalent pharmacy practice experience in health-system pharmacy practice, ambulatory, or managed care pharmacy services.
• PharmD required. Graduate study in a business, public health, or health policy field will be favorably considered.
• 7-10 years’ experience in the healthcare industry with focus on pharmacy benefit management, provider strategies and/or health plan business model
• Experience in a managed care setting, either from the provider, the payer, or the PBM side of the industry, is required.
• Prior experience in drug policy analysis and drug formulary management highly preferred
• Experience in direct supervision of technical support staff for clinical and/or service/operational programs is preferred.

Location

Boston

Time Type

Full time