Director Clinical Pharmacy at Independence Blue Cross LLC in Philadelphia, Pennsylvania

Job Description:

Our organization is looking for dynamic individuals who love to learn, thrive on innovation, and are open to exploring new ways to achieve our goals.  If this describes you, we want to speak with you. You can help us achieve our vision to lead nationally in innovating equitable whole-person health.

The Director of Clinical Pharmacy is responsible for the development, oversight and management of clinical pharmacy programs including, but not limited to, formulary creation and management for Commercial and Medicare business, regulatory requirements, and clinical pharmacy support to the organization. The Director will have primary responsibility for strategic planning, development, implementation, and management of pharmacy services to ensure medication management, and compliance with healthcare regulations. In conjunction with these responsibilities, the Director will lead a team of pharmacists and collaborate with internal partners to coordinate the development of clinical programs that attract and retain pharmacy benefits which support membership growth, improve clinical outcomes and reduce overall costs.

 Responsibilities:

• Collaborate with senior leadership to develop the strategic direction of pharmacy services.


•  Develop and implement a comprehensive clinical pharmacy strategy aligned with the Independence overall business objectives.


• Collaborate with internal Part D matrix colleagues to help develop overarching Part D strategy, providing thought leadership, strategic insights on product development, pricing/bids, formulary analysis, regulatory change impact analysis, Star performance, membership growth/mix impact and profitability.


• Establish with the Pharmacy Benefit Manager (PBM) a strong and strategic working relationship, including support to the P&L in the development of a multi-year, Medicare Advantage-specific, road map to ensure cohesive alignment with a critical business partner.


• Provide early leadership to move approved ideas into execution. As the early driver of execution of approved products and capabilities, begins the execution of business plans and creatively solves product design, financial, and administrative challenges.


• Leads and provides oversight and support for Pharmacy & Therapeutics Committee activities to evaluate new-to-market therapies, develop new criteria for coverage, and ensure that clinical programs are consistent with the latest guidelines and current evidence-based practices, as well as performing to achieve desired outcomes. 


• Drive initiatives for continuous quality improvement in clinical pharmacy, focusing on measurement adherence and outcomes.


• Responsible for providing leadership and oversight for the development of clinical program strategies, segment-specific formularies, and competitive programs.


• Responsible for the development and implementation of the clinical pharmacy policies and guidelines.


• Accountable for the measurement of initiatives or actions to ensure desired outcomes are achieved.


• Leads the team responsible for monitoring the drug utilization across medical and pharmacy benefits.


• Collaboes with PBM, and clinical teams to ensure formulary and programs are aligned.


• Responsible to develop drug utilization and formulary initiatives that optimize therapeutic outcomes, reduce the risk of drug-related problems, and ensure the use of cost-effective pharmacotherapy throughout the plan’s formularies and plan designs.


• Responsible for achievement of the Pharmacy Department’s overall quality goals, whether Stars, HEDIS or NCQA and ensure there are programs in place for each of the pharmacy-assigned components of those overarching quality programs.


• Provide clinical program leadership to ensure accurate, timely completion of all submission and clinically sound and fiscally responsible formulary management deliverables.


• Accountable for achievement of forecasted financial components of pharmacy, including projected spend, rebates, and cost savings targets to meet segment expectations.


• Develop an excellent network within the organization and have strong relationship building skills; passion and energy for driving and supporting change as well as the ability to lead multiple and varied initiatives simultaneously will be key.


• Stay current on emerging drug therapies, treatment guidelines, and advancements in clinical pharmacy practices.


• Ensure compliance with all applicable federal and state laws, regulations, and accreditation standards.

Qualifications:

• Doctor of Pharmacy (PharmD) degree from an accredited college of pharmacy is required.


• Master’s degree or MBA preferred.


• Minimum of 10 to 12 years of clinical pharmacy experience, with at least 5 years of leadership experience in a health plan or managed care role.


• Formulary design, Part D, and/or PBM experience highly preferred


• Active pharmacist license in the state of practice


• Proven track record of successful program development


• Strong strategic leadership and management abilities, with a focus on team development and collaboration.


• In-depth knowledge of clinical pharmacology, therapeutics, and medication management practices.


• Excellent communication and interpersonal skills.


• Ability to analyze data, develop reports, and make evidence-based decisions to improve clinical pharmacy services.


• Knowledge of regulatory requirements, compliance, and best practices in medication safety.


• Ability to prioritize tasks and manage multiple projects in a dynamic healthcare environment.


• Ability to foster a collaborative team environment.

Independence has implemented a “Hybrid” model which consists of Associates working in the office 3 days a week (Tuesday, Wednesday & Thursday) and remotely 2 days a week (Monday & Friday). This role is designated as a role that fits into the “Hybrid” model. While associates may work remotely on our designated remote days, the work must be performed in the Tri-State Area of Delaware, New Jersey or Pennsylvania

Independence Blue Cross is an Equal Opportunity and Affirmative Action Employer. All qualified applicants will receive consideration for employment without regard to their age, race, color, religion, sex, national origin, sexual orientation, protected veteran status, or disability.

 

Must have an Android or iOS device which is compatible with the free Microsoft Authenticator app.

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