Senior Director, Pharmaceutical Services

What you can expect! Find joy in serving others with IEHP! We welcome you to join us in “healing and inspiring the human spirit” and to pivot from a “job” opportunity to an authentic experience! Reporting to the Vice President, Pharmacy, the Senior Director, Pharmaceutical Services leads the strategic direction, clinical oversight, and operational execution of IEHP’s pharmaceutical program for IEHP Medi Cal, DSNP, and Exchange members, and is responsible for ensuring appropriate utilization management through evidence based UM criteria, audit ready documentation, and strengthened cost containment protocols. The role demonstrates advanced expertise in CMS, DHCS, DMHC, MDV audits and NCQA survey readiness and oversight, leading corrective action implementation and continuous quality improvement, while maintaining comprehensive regulatory compliance across DHCS, DMHC, CMS and NCQA. In addition, the Senior Director oversees the optimization of Pharmacy Benefit Management (PBM) performance, drives cost effective utilization, enhances member health outcomes, and ensures coordination of benefits and services with the DHCS Medi Cal Rx PBM, supporting IEHP’s strategic plans to improve chronic/preventative care, member experience, HEDIS, Stars and CAHPS performance. Commitment to Quality: The IEHP Team is committed to incorporate IEHP’s Quality Program goals including, but not limited to, HEDIS, CAHPS, and NCQA Accreditation. Perks IEHP is not only committed to healing and inspiring the human spirit of our Members, but we also aim to match our team members with the same energy by providing prime benefits and more. Competitive salary.Hybrid schedule. State of the art fitness center on-site.Medical Insurance with Dental and Vision.Life, short-term, and long-term disability optionsCareer advancement opportunities and professional development.Wellness programs that promote a healthy work-life balance.Flexible Spending Account – Health Care/ChildcareCalPERS retirement457(b) option with a contribution matchPaid life insurance for employeesPet care insurance Education & Requirements At least ten (10) years of experience in:-Leading the strategic direction, operational efficiency, and financial performance of the pharmacy department. This role encompasses various responsibilities, including leading teams, managing budgets, ensuring compliance, and driving quality improvement initiativesSenior level management, policy development and decision-making, with development and implementation of management best practicesSenior level management of a pharmacy benefit program spanning Medicare, Medi-Cal and ExchangePharmacy Benefit Management (PBM) oversight (CMS and Commercial)Clinical knowledge in implementing quality and clinical pharmaceutical programs (CMS star rating programs, DHCS MCAS measure improvement, NCQA quality programs)Leading and directing a team of clinical and operational pharmacists, pharmaceutical technicians, analysts, and special program managersAnnual budget managementPast successes in:Identifying trends or changes in treatment patterns and developing / implementing program changes to accommodate treatment changesImplementing innovative cost containment policies and proceduresImplementing quality assurance programsEmpowering staff to succeed through education and appropriate workPharm. D. from an accredited institution requiredMBA from an accredited institution preferredPossession of an active, unrestricted, and unencumbered Registered Pharmacist license issued by the California State Board of Pharmacy required Key Qualifications Comprehensive knowledge of:CMS, DHCS, DMHC and NCQA pharmacy regulationsBusiness principles and techniques of administration, organization, and management within the healthcare industry Strategic and operational planning Healthcare economicsPersonnel administrationFederal and state of California healthcare statutes, regulations, and rulesHealthcare industry trendsNegotiating with various pharmacy industry stakeholdersRegional pharmacy communityExcellent writing and communication skills and excellent organizational skillsMust have grit and attention to detail Start your journey towards a thriving future with IEHP and apply TODAY! Pay Range $246,355.20 USD Annually - $344,905.60 USD Annually