Vice President, Pharmacy

Overview 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 Chief Medical Officer, the Vice President of Pharmacy serves as a key member of the executive leadership team, providing strategic direction, clinical oversight, and operational excellence across all pharmacy-related functions at IEHP ensuring members have access to safe, effective, and affordable medications. This role is accountable for pharmacy benefit design, formulary management, utilization strategies, specialty pharmacy oversight, and vendor partnerships (including PBMs), while ensuring pharmacy operations are aligned with IEHP's mission to deliver quality, member-focused managed care. As a senior leader, the Vice President ensures full compliance with regulatory requirements (i.e., DHCS, DMHC, CMS and NCQA) and drives improvements in optimization of Pharmacy Benefit Management (PBM) performance, cost-effective utilization, quality performance (NCQA, CMS Stars etc.), and population health. This position collaborates cross-functionally with executive peers, clinical leaders, and external partners to align pharmacy operations with IEHP's strategic goals, fiscal stewardship, and commitment to health equity. The Vice President also serves as a thought leader in pharmacy innovation, leveraging data, technology, and policy insights to shape the future of pharmacy services at IEHP for all lines of business. 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. Additional Benefits 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 • State of the art fitness center on-site • Medical Insurance with Dental and Vision • Life, short-term, and long-term disability options • Career advancement opportunities and professional development • Wellness programs that promote a healthy work-life balance • Flexible Spending Account - Health Care/Childcare • CalPERS retirement • 457(b) option with a contribution match • Paid life insurance for employees • Pet care insurance Key Responsibilities 1. Strategic Leadership & Enterprise Pharmacy Oversight: • Develop and lead the execution of IEHP's enterprise-wide pharmacy strategy to support and advance clinical excellence, affordability, and member satisfaction across all lines of business. • Develop and implement a pharmacy strategy aligned with organizational goals for Medi-Cal, Medicare, and Exchange lines of business. • Serve as a strategic partner to leaders across Provider Services, Quality, Case Management, Finance, and Actuarial to drive improved member health, experience operations and pharmacy innovation. • Represent the pharmacy department in cross-functional meetings, regulatory discussions, and industry forums. • Lead innovation in pharmacy benefit models, including value-based care and outcomes-driven programs 2. Financial Stewardship • Oversee pharmacy financial performance, including budget development, forecasting, and strategic cost management. • Identify and implement cost containment strategies that preserve clinical integrity, member access, and high-quality care. • Monitor and respond to drug spend trends, including specialty and advanced therapies, and implement strategies to mitigate rising costs. 3. Specialty & Advanced Therapies • Lead strategy and oversight in coordination with Medical Policy for specialty pharmacy treatments, including biologics, oncology, and rare disease treatments. • Design, develop, and manage innovative programs for cell and gene therapies, ensuring appropriate utilization, affordability, and member access. • Collaborate with providers, manufacturers, and regulators to establish evidence-based pathways and coverage policies for advanced therapies. • Monitor emerging therapies and proactively design coverage policies to balance innovation with sustainability. 4. Leadership & Team Development • Lead and mentor pharmacy leadership teams, fostering a culture of innovation and accountability. • Build cross-functional collaboration across medical management, quality, and provider relations. • Represent IEHP in industry forums, regulatory discussions, and community partnerships. Qualifications Education & Requirement • Required: Ten (10) or more years of experience of: • 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 initiatives. • Senior level management, policy development and decision-making, with development and implementation of management best practices. • Senior level management of a pharmacy benefit program spanning Medicare, Medi-Cal and Exchange. • Pharmacy Benefit Management (PBM) oversight (CMS and Commercial). • Doctor of Pharmacy or Medicine from an accredited institution required. • Master's degree in Business Administration, or related field, from an accredited institution preferred. • Possession of an active, unrestricted, and unencumbered Registered Pharmacist license issued by the California State Board of Pharmacy required. Key Qualifications • Valid California Driver's License preferred. • Expert comprehensive knowledge and understanding of: • CMS, DHCS, DMHC and NCQA pharmacy regulations. • Business principles and techniques of administration, organization, and management within the healthcare industry. • Strategic and operational planning. • Personnel administration. • Federal and state of California healthcare statutes, regulations, and rules. • Healthcare industry trends. • Negotiating with various pharmacy industry stakeholders. • Technical understanding of Health Plan Part D requirements including, but not limited to, drug plan customer service, member complaints, member experience, and drug safety and accuracy of drug pricing. • Understanding in building high performing teams, as well as leading teams. • Knowledge of computers including Microsoft Office (Word, Excel, PowerPoint) and reporting, database, analytics applications. Strong managerial, motivational, and presentation skills. Clinical data analysis and trending skills. Training, teaching, and mentoring skills. Decision making and problem-solving skills. Skilled in supervising and leading high performing teams to meet deadlines. Superior communication skills, at all levels of the organization, including writing and presentation skills. • Attention to detail. Ability to work independently and within a team environment. Change agent. Customer service orientation. Start your journey towards a thriving future with IEHP and apply TODAY! Work Model Location This position is on a hybrid work schedule. (Monday & Friday - remote, Tuesday - Thursday onsite in Rancho Cucamonga, CA.) Pay Range USD $280,841.60 - USD $393,182.40 /Yr. Apply tot his job