Director of Pharmacy

Overview

UNITE HERE HEALTH serves over 200,000 workers and their families in the hospitality and gaming industry nationwide. Our desire to be innovative and progressive drives us to develop impactful programs and benefits designed to engage our participants in managing their own health and healthcare. Our vision is exciting and challenging. Please read on to learn more about this great opportunity!

Office

Location:

St. Louis Square (Las Vegas Blvd.) and is a hybrid position - This is a Culinary Health Fund position

• The Director of Pharmacy is responsible for setting the vision and leading the strategic direction and day-to-day operations of The Culinary Health Fund’s PBM and retail pharmacy programs. This role ensures that key business, operational, and financial objectives are consistently achieved. The Director oversees clinical pharmacy operations, manages subcontracted partners supporting core PBM functions—including pharmacy administration, pharmacy network management, and rebate services—and directs the pharmacy analytics function.
  
  Reporting to the VP of Operations – Las Vegas, the Director of Pharmacy works closely with internal teams, external partners, and senior leadership to advance the overall goals of the pharmacy program.
• Oversee the development, negotiation, and implementation of pharmacy benefit management programs for health plans and employers.
• Provides leadership and accountability for the performance and results of The Culinary Health Fund’s PBM and retail pharmacies.
• Develops and monitors the pharmacy clinical policies and programs, where appropriate.
• Leads the development of innovative clinical solutions to help manage the cost of the Fund’s pharmacy benefits, including but not limited to medication therapy management services for high-risk and general populations.
• Leads the creation, maintenance, and enhancement of formularies for a variety of patient populations while working with lead clinicians and designated committees.
• Ensures the success of Pharmacy Utilization Management, Prior Authorization, and other controls for all managed populations.
• Negotiate Contracts:
  Work with pharmacies and pharmaceutical manufacturers to secure cost-effective medication options and manage rebate contracts.
• Data Analysis:
  Analyze drug utilization data to inform formulary strategies and ensure appropriate medication use.
• Analyzing pharmacy claims data to monitor drug spend and forecast trends.
• Develops, implements, and ensures continuous quality and process improvement to deliver effective and efficient programs and services.
• Regulatory Compliance:
  Ensure adherence to state and federal regulations regarding pharmacy benefits and prescription drug programs.
• Develops, maintains, and oversees local, state, and national regulatory compliance for all PBM services.
• Provides oversight to ensure successful outcome of compliance audits/reviews (e.g., URAC).
• Relationship Management:
  Maintain relationships with pharmacies, healthcare providers, and other stakeholders to facilitate effective communication and service delivery.
• Collaborates with the Fund’s departments, Regional Directors and external stakeholders on service delivery including development and implementation of a network of community pharmacies to support broader healthcare delivery programs and to resolve claim issues.
• Accountable for the performance of the various vendors engaged by the PBM for Pharmacy programs, analytical services and resolves issues affecting the service or financial objectives of the PBM.
• Facilitates communication with network pharmacies.
• Cost Management:
  Identifying cost-saving opportunities and developing strategies to reduce expenses.
• Provides leadership oversight for the assessment of value-based pharmacy programs to continually enhance the pharmacy programs.

• 5 ~ 7+ years of direct experience
• Working knowledge and experience in PBM contracts, benefit programs, funding arrangements, administrative arrangements, insurance products, compliance, etc.
• Strong pharmaceutical knowledge including clinical aspects and formulary development
• Knowledge of a wide-range of patient-centered and pharmacy…