Position OverviewThe Vice President, National Pharmacy Services serves as the executive leader responsible for the strategic direction, operational performance, clinical effectiveness, regulatory compliance, and growth of all pharmacy-related programs and services across PonosCare.
This role is responsible for building and leading a national pharmacy model that integrates medication optimization, specialty pharmacy management, value-based care initiatives, predictive medicine, population health analytics, and pharmacist-led interventions to improve member outcomes while reducing healthcare costs.
The Vice President will work collaboratively with Clinical Operations, Behavioral Health, Engagement, Eligibility, Information Technology, Data Analytics, and Provider Relations teams to create a fully integrated pharmacy ecosystem supporting members with complex chronic conditions.
This leader will be responsible for designing and implementing innovative pharmacy strategies that align with payer expectations, value-based contracts, quality measures, and PonosCare's long-term growth strategy.
Core ResponsibilitiesExecutive Leadership & Strategy- Develop and execute the national pharmacy services strategy.
- Serve as the executive pharmacy leader for all markets and future state expansions.
- Establish pharmacy goals, objectives, and key performance indicators.
- Develop annual operating plans and budgets for pharmacy services.
- Provide strategic recommendations to the Executive Leadership Team.
- Participate in organizational growth planning and expansion initiatives.
- Represent pharmacy services during payer, provider, client, and board meetings.
Clinical Pharmacy Operations- Design and oversee pharmacist-led care management programs.
- Establish medication optimization programs across all disease states.
- Develop specialty pharmacy management strategies.
- Implement evidence-based medication therapy management programs.
- Create medication adherence and compliance initiatives.
- Oversee medication reconciliation and transition-of-care programs.
- Establish clinical pathways and medication intervention protocols.
Disease-State Management- Provide pharmacy oversight and intervention strategies for: Multiple Sclerosis, Human Immunodeficiency Virus, Crohn's Disease, Ulcerative Colitis, Rheumatoid Arthritis, Psoriatic Arthritis, Sickle Cell Disease, Chronic Kidney Disease, Heart Failure, Diabetes, and Behavioral Health Conditions
- Develop clinical protocols that improve outcomes while reducing total cost of care.
Predictive Medicine & Analytics- Collaborate with Information Technology and Predictive Medicine teams.
- Utilize predictive analytics to identify high-risk members.
- Develop pharmacy intervention triggers based upon risk scoring.
- Create pharmacist review workflows for identified members.
- Monitor medication utilization trends and adherence patterns.
- Utilize artificial intelligence and predictive models to improve intervention effectiveness.
- Develop pharmacy dashboards and reporting tools.
Value-Based Care Programs- Support all value-based care contracts and payer initiatives.
- Develop pharmacy-specific quality improvement strategies.
- Improve medication adherence performance measures.
- Reduce avoidable hospital admissions and emergency department utilization.
- Support risk adjustment and quality metric improvement efforts.
- Participate in contract implementation and operational readiness activities.
Specialty Pharmacy Management- Develop relationships with specialty pharmacies and pharmacy benefit managers.
- Evaluate opportunities for specialty pharmacy sourcing.
- Implement biosimilar conversion programs.
- Identify inappropriate medication utilization.
- Develop prior authorization optimization strategies.
- Monitor specialty medication outcomes and cost savings.
Financial Management- Develop pharmacy budgets and forecasts.
- Monitor pharmacy program financial performance.
- Identify cost-saving opportunities.
- Develop return-on-investment analyses for pharmacy programs.
- Partner with Finance on medication cost management initiatives.
- Support revenue generation opportunities through pharmacy interventions.
Regulatory Compliance- Ensure compliance with all applicable federal and state regulations.
- Maintain pharmacy-related accreditation readiness.
- Support audits and regulatory reviews.
- Develop pharmacy policies and procedures.
- Monitor regulatory changes impacting pharmacy operations.
Leadership & Team Development- Recruit, develop, and retain pharmacy talent.
- Lead Clinical Pharmacists, Pharmacy Technicians, and Pharmacy Operations staff.
- Establish performance standards and accountability measures.
- Develop leadership succession plans.
- Promote a culture of collaboration, innovation, and continuous improvement.
QUALIFICATIONS AND EDUCATION- Doctor of Pharmacy (PharmD) required
- Master of Business Administration (MBA), Master of Public Health (MPH), Healthcare Administration Degree (preferred)
- Active Pharmacist license required. Preferred in multiple states licenses and Board Certification (BCPS, BCACP, or equivalent).
- Minimum 10 years of progressive pharmacy leadership experience.
- Minimum 5 years leading pharmacy teams.
- Experience within managed care, value-based care, population health, specialty pharmacy, or healthcare services organizations.
- Multi-state healthcare operations experience. (preferred)
- Predictive medicine or population health experience. (preferred)
- Experience supporting payer contracts and risk-based arrangements. (preferred)
- Experience managing pharmacy budgets and performance metrics.
- Experience working with Medicare, Medicaid, and healthcare regulatory agencies
- Knowledge of pharmacy benefit management (PBM) operations preferred
- Strong knowledge of clinical information systems including electronic medical records (EMR)
- Experience supporting risk management and medication safety protocols
- Strong analytical skills supporting medication utilization review and cost management
- Strong leadership, communication, and strategic planning skills
