VHP Pharmacy Services Division Director

Under general direction, plans, develops, directs, monitors, and evaluates the pharmacy services program for Valley Health Plan (VHP), including managing the third-party Pharmacy Benefit Manager (PBM) and the VHP Pharmacy services staff. - Plans, organizes, evaluates, and directs the work of professional and para-professional personnel; - Selects, trains, and evaluates subordinate staff; - Collaborates with Executive Management and Consultants to develop, manage, and execute comprehensive business plans, pharmacy services, and business operations; - Develops and implements VHP pharmacy policies, procedures, and workflows; - Assures compliance of managed care pharmacy operations with Federal and State laws and regulations, and standards from accrediting bodies; - Designs, develops, and monitors key performance indicators on a scheduled basis to communicate pharmacy performance to health plan senior staff, internal committees, contracted groups, and regulators with regards to pharmacy utilization, quality metrics, pharmacy provider access, and drug trends; - Assumes responsibility of overseeing the third-party Pharmacy Benefit Manager (PBM) personnel engaged in delegated pharmacy activities; - Coordinates matters relating to the utilization and control of medication, special investigational drugs, or non-formulary drugs; - Edits, revises, and maintains the Valley Health Plan formularies and notifies appropriate entities of approved drugs, utilization management edits, and clinical criteria; - Analyzes pharmacy vendor data to determine opportunities for mitigation of fraud, waste, and abuse, and improvement of overall vendor performance and assumes responsibility for implementing process improvements for identified issues; - Develops drug utilization reports identifying strategic initiatives and recommends/proposes solutions to CMO, Pharmacy and Therapeutic Committee, Special Cases Unit, or other health plan committees to improve clinical outcome, improve efficiency in drug usage, and manage drug cost savings; - Directs the strategy, planning and implementation of VHP pharmacy systems migrations and information technology application enhancements/updates; - Participates, researches, and validates materials for both internal and external program audits, and performs scheduled audits of delegated activities, and reports outcomes; - Serves as a subject matter expert and point of contact for all health plan pharmacy related activities for all internal County Departments and external regulators, partners, or vendors; - Resolves escalated VHP pharmacy issues; - Provides pharmacy guidance to various departments within VHP; - Actively participates as a voting member of Valley Health Plan's Pharmacy and Therapeutics Committee, and standing member for other committees at the health plan and outside the health plan representing pharmacy related performance and activities; - Represents Valley Health Plan Pharmacy Department to internal and external stakeholders; - May be assigned as a Disaster Service Worker, as required; - Performs related work as required. Sufficient education, training, and experience to demonstrate the possession and direct application of the following knowledge and abilities: **Training and Experience Note:** The knowledge and abilities required to perform this function are attained through possession of a Doctor of Pharmacy (PharmD) degree and Three (3) years of experience planning, organizing, evaluating, and directing the work of professional and paraprofessional pharmacy personnel, and two (2) years of experience within a managed care organization or health plan pharmacy. The supervisory experience may be inclusive of the managed care or health plan pharmacy experience. **Special Requirements** - Possession of a valid license to practice as a Pharmacist in the State of California at the time of appointment. - Ability to travel to alternate locations in the course of work. If driving, possession of a valid Californi…