Director, Pharmacy
at Health Plan of San Joaquin

Date Posted: 7/9/2018

Job Description

Under limited supervision, responsible for overseeing the implementation of strategic and operational objectives and plans to support quality and cost effective care, and corporate decision-making. Work is varied and highly complex, and requires a high degree of discretion and independent judgment.
  • Manager, Clinical Pharmacy; Pharmacists; Pharmacy Technicians; Pharmacy Residents and  students; Pharmacy Coordinators

Essential Functions
  • Oversees pharmacy prior authorization process: conducts clinical review of pharmacy prior authorizations; approves/denies or offers formulary or therapeutic alternatives according to HPSJ’s pharmacy criteria.
  • Promotes clinically appropriate prescribing practices, which conform to HPSJ as well as national practice guidelines.
  • Leads he Identification, development s and implementation of clinically effective and cost-effective pharmacy management, including but not limited to appropriate use criteria of medications, step edits, PA criteria or quantity limits; monitors and takes action based on results.
  • Leads and or supports the identification, development and implementation of HPSJ’s pharmacy based care management initiatives: compiles and analyzes medical and pharmacy data; identifies related member populations; recommends and develops appropriate physician and member interventions; monitors and takes action on results.
  • Supervises quantitative and qualitative analyses/evaluation; collaborates with medical directors and others to identify opportunities for improving cost effectiveness and quality of care and services, and to monitor and evaluate performance and to evaluate outcomes of programs related to pharmacy programs and interventions.
  • Anticipates technology needs; oversees development and implementation; collaborates to improve or upgrade current technology solutions; manages vendor performance and relationships.
  • Oversees the implementation and administration of HPSJ’s pharmacy benefit by contracted PBM: monitors performance; identifies and resolves performance issues.
  • Develops and prepares effective decision support tools and models for accurate evaluation of performance and to assist in management decision-making.
  • Assists the Pharmacy and Therapeutics committee in the development, maintenance and evaluation of the HPSJ’s drug formulary, clinically effective and cost-effective pharmacy management strategies, including but not limited to appropriate use criteria, step edits or quantity limits, and fraud and abuse.
  • Develops and maintains a Drug Utilization Review Program to meet all the regulatory requirements.
  • Ensures consistent dashboard reporting, adhoc reports as needed and analytics to support both cost of care and quality initiatives.
  • Monitors the pharmaceutical trends and new technology proactively to assess the impact on HPSJ and its members.
  • Develops or oversees the development of pharmacy policies and procedures; ensures the development and implementation of appropriate companion procedures, guidelines and other documents.
  • Develops and manages department budget.
  • Promotes and maintains, and ensures that direct reports promote and maintain an environment that supports HPSJ’s strategy, vision, mission and values.
  • Hires, develops, supervises and retains an adequate and competent staff.
  • Directs the pharmacy residency program including curriculum development, accreditation and program growth.
  • Demonstrates leadership within the pharmacy department or within the organization, through a documented record of improvements in and contributions to pharmacy practice.
  • Demonstrates ongoing professionalism and contribution to the profession
  • Chairs the Pharmacy &Therapeutics Committee and participates actively in other UM/QM committees.
  • Organization and leadership of a residency advisory committee that provides guidance for residency program conduct and related issues.
  • Oversight of the progression of residents within the program and documentation of completed requirements.
  • Implementing use of criteria for appointment and reappointment of preceptors.
  • Evaluation, skills assessment, and development of preceptors in the program.
  • Creating and implementing a preceptor development plan for the residency program.
  • Continuous residency program improvement in conjunction with the residency advisory committee and working with pharmacy administration.

Non-Essential Functions
  • Other duties as required.

Job Requirements

Required Skills
  • Expert knowledge of and ability to apply and facilitate the adoption of best practices.
  • In-depth knowledge of the business, economic, demographic and political trends and developments affecting managed care, Medi-Cal and/or Medicaid.
  • In-depth knowledge of Medicaid, Medi-Cal and/or Medicare benefits, and reimbursement and payment structures.
  • Expert knowledge of the principles and practices of managed care as they relate to pharmacy.
  • In-depth knowledge of HEDIS and NCQA as they related to pharmacy and analytics.
  • Advanced problem solving, financial modeling and analytical skills, with ability to analyze and resolve complex problems of broad scope, develop effective action plans and implement to successful conclusion.
  • Advanced leadership skills, including but not limited to the ability to support corporate objectives, establish direction, build alliances, and inspire and motivate others across the organization and externally.
  • Ability to create, execute and monitor relevant strategic and business plans.
  • Demonstrated ability to articulate and support HPSJ’s vision, mission, values and strategy, integrate into management practices, and foster their manifestation among staff.
  • Strong management skills, including but not limited to the ability to supervise staff in a manner that maximizes employee performance and business results.
  • Strong collaboration skills, including but not limited to the ability to create and foster a collaborative work environment, and organize people and resources to solve problems and identify opportunities.
  • Strong interpersonal skills, including the ability to establish and maintain effective working relationships with individuals at all levels inside and outside of HPSJ.
  • Strong oral and written communication skills, including the ability to communicate professionally and persuasively to diverse individuals and groups inside and outside of HPSJ.
  • Advanced presentation skills, including but not limited to the ability to tailor presentations to a specific audience, be persuasive and identify key messages.
  • Strong skills in budget development and management.
  • Strong project management skills, including the ability to manage organizational-wide projects to successful conclusion.
  • In-depth knowledge of change management theory, with ability to anticipate and implement effectively.
  • Advanced Excel skills, including the ability to create complex formulas and templates.
  • Advanced skills in Word, Excel and Outlook, including the ability to develop spreadsheets, formulas, and create tables and graphs.
  • Ability to speak and be understood in English.
  • Ability to handle confidential information with appropriate discretion

Required Experience
  • Doctor of Pharmacy from an accredited college or university; and
  • At least seven years’ experience in all aspects of pharmacy administration in managed care; and
  • At least six years in a management/supervisory capacity in pharmacy; or
  • Equivalent combination of education and experience.

  • One of the following to qualify to be residency program director:
    • Completed ASHP accredited PGY1 residency followed by a minimum of three years of pharmacy practice experience.
    • Completed ASHP-accredited PGY1 and PGY2 residencies with one or more years of pharmacy practice experience.
    • Without completion of an ASHP-accredited residency, have five or more years of pharmacy practice experience

  • Completion of managed care pharmacy or clinical residency.
  • Experience selecting and implementing pharmacy benefit management systems.
  • Medicaid managed care experience especially Medi-Cal experience.

Licenses, Certification
  • Unrestricted California State Board of Pharmacy license.


Job Snapshot

About Us

For over 20 years, Health Plan of San Joaquin (HPSJ) has delivered access to hands-on, high-touch, quality health care for our diverse Central Valley communities. We do this by remaining as we began: nimble, resourceful and local. After two decades of communitywide partnerships and service:

  • More residents want to be our members
  • More providers prefer to be in our network
  • Hundreds of community-based organizations continue to come to us, whether for leadership, to make common cause on behalf of the health and well-being of our residents, or to host health condition-focused outreach and initiatives

For HPSJ employees, our commitment is professional and our dedication is personal: To provide health care value and advance wellness through community partnerships. We are a mirror to the rich cultural diversity of our service area, San Joaquin and Stanislaus counties. Our employees appreciate several benefits while working for HPSJ, such as four medical plan options, dental, vision, three retirement plans, and the opportunity to collaborate with others who are dedicated to providing high quality healthcare to our members.

2016 HPSJ Community Report – The Story of Us

Each of our over 300 HPSJ employees can take justifiable pride in the role they play to make possible access to quality health care for over 340,000 members. We invite you to walk through the 2016 HPSJ Community Report, and hope you find it informative. For each of us at HPSJ, it has generated justifiable feelings of personal and professional pride.

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