VP, Pharmacy Benefits

Provides executive leadership, strategic direction, and decision making for Program wide Pharmacy Benefits Plan including - Medicare Part D, Commercial Benefits, Self-Funding, Exchanges, and Medicaid.

Responsible for Pharmacy Benefit Management (PBM) Vendor Management, Pharmacy Service Center, and National Pharmacy Fee Schedule.

Positions pharmacy as a growth enabler and market differentiator by delivering integrated benefit solutions that support acquisition, retention, and enterprise brand value.

Lead strategist for development and management of pharmacy benefit offerings that meet customer requirements, maintain an appropriate risk pool, promote quality, and achieve financial targets.

Essential Responsibilities

• Provides executive leadership and oversight to over 80 departmental staff including pharmacists, benefit analysts, information technology, and finance personnel to meet internal and external customer needs.
• Expected to lead, serve, and participate on various committees at the senior leadership level.
• Assures appropriate design and execution of the pharmacy benefits plan to meet operational, clinical, regulatory, and financial objectives, in primary collaboration with pharmacy executives.
• Plays a key role in aligning pharmacy strategy with market growth, enterprise performance goals, and health plan product development.
• Defines and leads governance structures for pharmacy benefit decision-making-ensuring transparency, shared accountability, and alignment with enterprise priorities.
• Leads through influence in a highly matrixed environment-navigating market variability, aligning diverse stakeholders, and building consensus for transformative change.
• Champions the voice of the customer (members, purchasers, and brokers) to ensure pharmacy benefits meet evolving expectations and drive satisfaction, retention, and sales.
• Serves as executive pharmacy sponsor or co-sponsor for health plan initiatives and projects impacting pharmacy.
• Provides strategic support for applicable pharmacy initiatives with Risant.

Requirements

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