Avera Health · 12 hours ago
Senior Director - Pharmacy Operations - Avera Health Plans
Sioux Falls, SD
Full-time
Onsite
Director/Executive
7+ years expAvera Health is a healthcare organization dedicated to providing compassionate care, and they are seeking a Senior Director of Health Plan Pharmacy Operations. This role involves leading pharmacy operations, enhancing affordability and quality of pharmacy services, and collaborating with various teams to exceed customer expectations.
Health CareHospitalMedical Device
Responsibilities
Develop and execute pharmacy strategies that align with the corporate and divisional objectives. Strategies focus on developing and defining procedures and systems to support and achieve high pharmacy carve-in rates, and long-term goals and measures that are consistent with Avera Health Plans strategy
Cascade and communicate strategy and initiatives to Avera Health Plans and Avera Health business owners, team members, customers, and stakeholders. Provide strong leadership to motivate team and build trust. Provide strategic oversight to the Pharmacy & Therapeutics (P&T) committee as needed
Focus on delivering, in aggregate, the lowest net spend and trend through greater engagement with providers and members, targeted clinical programs, and an outsourced Pharmacy Benefits Manager (PBM) relationship
Lead the design and implementation of continuous improvements and enhancements of the Pharmacy program (including the benefit designs, formularies, etc.) using data and analytics. Assure lowest net spend and trend vs. market competitors while optimizing members pharmaceutical value and improving efficiency and service levels
Provide pharmacy direction and input to cross-functional teams to inform product development and innovation; provide pharmacy subject matter expertise and guidance regarding benefit design/redesign to ensure efficient pharmacy and medical benefit drug spend
Lead and manage collaboration with the Sales team to support the renewal, RFP, and new sales customer activities. Provide consultation to ensure appropriate pharmacy and medical drug benefit strategies are recommended, presented, and implemented
Develop, maintain, and strategically leverage strong rapport with external relationships such as PBM, local pharmacy associations, provider groups, employer groups and brokers. Ensure market competitive PBM and Specialty Pharmacy results while focusing on developing long-term value for customers through clinical pharmacy program innovation. Provide leadership and oversight of relationships with legislative and regulatory bodies
Responsibilities include interviewing, hiring, developing, training, and retaining employees; planning, assigning, and leading work; appraising performance; rewarding and coaching employees; addressing complaints and resolving problems
Qualification
Required
Pharmacist - Board of Pharmacy An active license in the state of practice Upon Hire
Pharmacist - Board of Pharmacy Pharmacist - other states as required upon request
Pharmacotherapy Specialty Certification (BCPS) - Board of Pharmacy Specialties (BPS) Upon Hire
4-6 years Progressive leadership experience within a health plan or PBM
7-9 years Healthcare industry, managed care, or PBM experience, or combination
Preferred
Doctorate (PHD) Doctorate of Pharmacy (Pharm. D)
Master's In Business Administration, Healthcare Administration, or Healthcare Management
Certificate of Completion (COC) - American Society of Health-System Pharmacists (ASHP) Awarded by the residency program accredited by ASHP (American Society of Health-System Pharmacists) Upon Hire
Benefits
PTO available day 1 for eligible hires.
Up to 5% employer matching contribution for retirement
Career development guided by hands-on training and mentorship
Company
Avera Health
Avera Health, an integrated health system based in Sioux Falls, SD, is committed to making a positive impact in the health and wellness of persons and communities.
Founded in 1897Sioux Falls, South Dakota, USA
5001-10000 employees
Funding
Current Stage
Late StageTotal Funding
$2.55MKey Investors
U.S. Department of JusticeBristol-Myers Squibb
2023-11-16Grant· $0.95M
2018-02-20Grant· $1.6M
Leadership Team
James J Breckenridge
SVP-Finance
Bob Sutton
Vice President of Community Relations
Recent News
2025-03-12
2024-02-19
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