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VP of Pharmacy

eternalHealth – The Next Generation of Medicare Advantage

Healthcare is confusing, but it doesn’t need to be. eternalHealth is a consumer-centric, Medicare Advantage Health Plan based in Boston. We are committed to creating long-lasting partnerships with our members, our providers, and you!

About the role: As the VP of Pharmacy with eternalHealth, you will report to the Chief Medical Officer (CMO) and be accountable for organizational leadership, performance, and operations for Pharmacy. This role offers the unique opportunity to be an integral part of eternalHealth’s growth and expansion initiatives in Medicare.

As the VP of Pharmacy, you will support the essential duties of eternalHealth to ensure we provide quality products and services for our members.

We provide a unique opportunity to be a part of a health plan in its beginning stages and by taking advantage of this rare opportunity, you will be able to have insight into all the operations and expertise that is required to run a successful and sustainable plan. Our team members are flexible and able to play different roles, while staying committed to teamwork and collaboration, and passionate about sustainable change.

Responsibilities:

• Drive action-oriented strategy to help health plan achieve Part D Quality/STAR Measures 4 STAR or Higher.
• Help to optimize the Pharmacy Portion of the Medical Loss Ratio through the right programs and initiatives

-Step therapy and

-Comprehensive Medication Review- steering to lower cost alternatives.

• Oversight of OptumRx
• GLP-1 Action Plan- High-cost drug action plan
• Strategic Product Planning Assistance, to create competitive and financially viable products.
• Own and manage day-to-day pharmacy operations, clinical programs and strategic initiatives.
• Ensure Pharmacy meets all applicable regulatory, statutory rules and requirements.
• Manage and oversee relationships and contractual commitments with all key vendors (e.g. Pharmacy Benefit Manager) supporting Pharmacy.
• Develop and maintain Pharmacy benefit design in conjunction with other eternalHealth stakeholders.
• Partner with the CMO and clinical management to ensure best-in-class clinical support and quality initiatives, including Star measures.
• Create and maintain policies and procedures and desktop work instructions for Pharmacy.
• Participate in Annual Readiness activities.
• Support audit activities and Centers for Medicare and Medicaid Services (CMS) facing consultation.
• Accountable for Pharmacy key performance indicators (KPIs) to identify performance opportunities and trends.
• Communicate our brand, values, and differentiators effectively and accurately.
• Maintain strict privacy and confidentiality in accordance with eternalHealth’s security standards.
• Other duties as assigned.

Requirements:

• Bachelor’s degree required in Pharmacy.
• Active Pharmacist license.
• Minimum of 5 years of Managed Care, Pharmacy Benefit Manager (PBM) experience.
• Ability to work in-person from our Boston based office.
• Strong understanding of CMS requirements related to Medicare Part D operations and compliance.
• You’re a relationship builder and a team player.
• Excellent written and verbal communication skills.
• Proficiency in Microsoft Word, Excel, and PowerPoint.
• Ability to think outside the box and offer creative and compliant solutions to existing and new problems.

Preferred:

• Solid Medicare Part D health plan or PBM experience.
• Prior experience with CMS program audits and Part D reporting.
• Excellent organizational and program management skills.

Working with eternalHealth: eternalHealth is an Equal Opportunity Employer which means that we are committed to upholding discrimination-free hiring practices. As a woman-led company, and one committed to diversity at all levels, we strive for an organization of inclusion and acceptance. We are changing healthcare for the better, starting with our own diverse and passionate teams. As an eternalHealth employee you will be empowered to contribute to our teams and strategy, regardless of previous healthcare experience. Our valued team members are encouraged and expected to offer new solutions and creative input, all while keeping in line with eternalHealth’s mission, values, and compliance standards.

Accommodations: Any eternalHealth applicant will be considered based entirely on their individual qualifications. Should you require reasonable accommodations during the application process (which may include a job-related assessment) please contact us at hr@eternalhealth.com.