Description
Position Purpose: Develop, implement and oversee the pharmacy benefit management program across multiple product lines in both centralized and regional environments with multiple locations. Ensure compliance with contractual guidelines of the corporation and health plans impacted by numerous regulatory agencies with complex and often conflicting requirements.
- Provides enterprise leadership for pharmacy clinical operations, including Pharmacy & Therapeutics (P&T) governance, formulary strategy, clinical policy oversight, and drug pipeline management to support quality, affordability, and regulatory compliance.
- Leads pharmacy trend management, high-cost therapy strategies, and manufacturer relationship management, including medical rebate strategy and negotiations, to optimize clinical and financial outcomes.
- Partners cross-functionally with Pharmacy, Product, Actuary, Medical Affairs, Compliance, PHCO, and Market teams to develop and execute enterprise pharmacy strategies that enhance member access and business performance.
- Oversees strategic planning for emerging therapies, formulary performance, and pharmacy spend management while ensuring readiness for evolving market and regulatory requirements.
- Evaluate program performance and recommend to State on program changes that would result in improved costs and higher quality.
- Responsible for developing and attaining pharmacy AOP initiatives and Per Member Per Month (PMPM) goal.
- Establish the strategic vision, objectives and policies and procedures for the pharmacy program in support of the corporate strategic vision.
- Participate in internal and external accreditation initiatives, relevant boards, task forces, committees, meetings and other activities.
- Manage relationships with and provide appropriate oversight of key vendors, including industry leading partners (e.g. ICER) and pharmaceutical companies.
- Performs other duties as assigned.
- Complies with all policies and standards.
Education/Experience: Bachelor's Degree in Pharmacy required.
PharmD preferred.
10+ years of clinical pharmacy care and experience required.
Thorough knowledge of pharmaceutical care and pharmacy benefit management practices.
Previous management experience including responsibilities for hiring, training, assigning work and managing performance of staff.
Quality improvement experience preferred.
Or equivalent experience acquired through accomplishments of applicable knowledge, duties, scope and skill reflective of the level of this position.
At Centene, we connect people to the care they need to live healthier lives — and the work you do here makes that impact real every day. You’ll take on meaningful challenges that directly support individuals, families, and communities, building your skills while making healthcare more accessible and effective. It’s work with a purpose you can see, backed by a team committed to improving lives well beyond the workday.
Centene offers a comprehensive benefits package including: competitive pay, health insurance, 401K and stock purchase plans, tuition reimbursement, paid time off plus holidays, and a flexible approach to work with remote, hybrid, field or office work schedules. Actual pay will be adjusted based on an individual's skills, experience, education, and other job-related factors permitted by law, including full-time or part-time status. Total compensation may also include additional forms of incentives. Benefits may be subject to program eligibility.
Centene is an equal opportunity employer that is committed to diversity, and values the ways in which we are different. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, veteran status, or other characteristic protected by applicable law.
Qualified applicants with arrest or conviction records will be considered in accordance with the LA County Ordinance and the California Fair Chance Act
