Managing Director, Clinical Pharmacy Strategy, Execution
Job Description:
• Provides strategic leadership for clinical pharmacy initiatives across all lines of business
• Oversee formulary, criteria, and prior authorization activities to ensure timely, compliant, and high-quality service delivery
• Accountable for monitoring drug utilization trends, guiding performance standards, and ensuring regulatory compliance to support affordability and member outcomes
• Lead the strategic direction, development, and execution of drug management programs
• Direct leadership staff responsible for formulary creation, criteria development and maintenance, prior authorization evaluations, and utilization management monitoring
• Oversee development and maintenance of clinical pharmacy policies and ensure compliance with accreditation standards (e.g., URAC, NCQA, CMS)
• Lead and develop a high-performing team, fostering a culture of accountability, engagement, and continuous improvement, and professional growth
• Coordinate with pharmacy benefit strategy leaders and corporate stakeholders to deliver competitive and cost-effective clinical services
• Lead audit preparation and compliance initiatives to ensure coverage review operations meet internal and external standards
• Ensure clinical functions meet expectations for value and affordability, driving continuous improvement and market responsiveness
Requirements:
• Doctor of Pharmacy (PharmD) degree required
• Minimum 10 years of managed care, PBM, and/or clinical experience required
• Minimum 5 years of supervisory/leadership responsibilities required
• Licensed in Tennessee to practice pharmacy, or eligible for licensure in the state of Tennessee to practice pharmacy
• Ability to lead coverage review operations and ensure compliance
• Expertise in policy development and audit readiness
• Skill in driving process improvements for service quality
• Strength in cross-functional collaboration with pharmacy and corporate teams
• Leadership in building and mentoring operational teams
Benefits:
• Flexible work arrangements
• Professional development
• Relocation assistance if required to reside in Chattanooga, TN
Apply Now
Apply Now
• Provides strategic leadership for clinical pharmacy initiatives across all lines of business
• Oversee formulary, criteria, and prior authorization activities to ensure timely, compliant, and high-quality service delivery
• Accountable for monitoring drug utilization trends, guiding performance standards, and ensuring regulatory compliance to support affordability and member outcomes
• Lead the strategic direction, development, and execution of drug management programs
• Direct leadership staff responsible for formulary creation, criteria development and maintenance, prior authorization evaluations, and utilization management monitoring
• Oversee development and maintenance of clinical pharmacy policies and ensure compliance with accreditation standards (e.g., URAC, NCQA, CMS)
• Lead and develop a high-performing team, fostering a culture of accountability, engagement, and continuous improvement, and professional growth
• Coordinate with pharmacy benefit strategy leaders and corporate stakeholders to deliver competitive and cost-effective clinical services
• Lead audit preparation and compliance initiatives to ensure coverage review operations meet internal and external standards
• Ensure clinical functions meet expectations for value and affordability, driving continuous improvement and market responsiveness
Requirements:
• Doctor of Pharmacy (PharmD) degree required
• Minimum 10 years of managed care, PBM, and/or clinical experience required
• Minimum 5 years of supervisory/leadership responsibilities required
• Licensed in Tennessee to practice pharmacy, or eligible for licensure in the state of Tennessee to practice pharmacy
• Ability to lead coverage review operations and ensure compliance
• Expertise in policy development and audit readiness
• Skill in driving process improvements for service quality
• Strength in cross-functional collaboration with pharmacy and corporate teams
• Leadership in building and mentoring operational teams
Benefits:
• Flexible work arrangements
• Professional development
• Relocation assistance if required to reside in Chattanooga, TN
Apply Now
Apply Now