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Director of Pharmacy, South San Francisco, CA

Health Plan of San Mateo


South San Francisco, CA

July 31, 2017


The Health Plan of San Mateo (HPSM), a managed care health plan, seeks a full time Director of Pharmacy to perform the following essential duties & responsibilities:

  • Responsible for development, implementation and monitoring of all Pharmacy initiatives.
  • Develop an overall pharmacy business plan and budget that will establish goals/targets and strategies to educate physicians/providers, and will include methods to measure and monitor the effectiveness and success of all pharmacy programs and services implemented.
  • Develop and implement pharmacy-related policies, procedures, guidelines and programs.
  • Develop and oversees strategies to control pharmacy quality, utilization and cost as well as to reduce variations in pharmacy practices.
  • Lead all pharmacy related quality programs including but not limited to pharmacy related Stars and HEDIS measures.
  • Define strategy to communicate treatment guidelines and policies to primary and specialty care physicians.
  • Work closely with Finance Department and informatics/analytics team to ensure accurate collection of pharmacy utilization data and reporting.
  • Identify opportunities for new pharmacy management programs and provides regular reporting on program performance.
  • Ensure that proper pre-authorization procedures are administered consistently and effectively while remaining up to date on all new medications and related policies.
  • Ensure pharmacy department meets regulatory compliance requirements.
  • Implement Medicare prescription benefit contracts.
  • Act as a liaison between HPSM and its external Pharmacy Benefits Managers (PBMs) with a focus on oversight of pharmacy claims processing and all aspects of the pharmacy benefit plans.
  • Attend all necessary department and inter-department meetings including Compliance Committee, Quality Improvement Committee, Utilization Management Committee, Chairperson for Pharmacy Committees, Operations, and department meetings.


Education and Experience:

  • Doctor of Pharmacy (Pharm D). California Pharmacy License, active, in good standing, no restrictions or/and Masters in Business Administration (MBA).
  • Five (5) or more years of experience in the pharmacy field with managed care experience. Three (3) or more years of experience in a management position. Experience with Medicare Part D required.

Knowledge of: Medicare Part D; Pharmacy risk contracting including rebate related issues; quality programs including Stars and Hedis measures; applicable State and federal regulations; Provider relations and working with various payor environments.

Ability to: Takes initiative; plans work and carries out tasks without detailed instructions. Ability to effectively communicate to large groups of physicians. Ability to effectively interact with physicians and employees at all levels of the organization. Ability to effectively oversee the development and implementation of new programs and systems, and modify existing programs and systems to better meet organizational goals. Proficient in MS Word, MS Excel, MS PowerPoint, and databases. Strong understanding of pharmacy risk and cost-effective prescribing alternatives. Ability to process and understand pharmacy utilization data. Excellent verbal and written communication skills. Public speaking skills.

Benefits Information: Excellent benefits package offered, including HPSM paid premiums for employee’s Medical, Dental and Vision coverage. Employee pays a small portion of the dependent premiums (5%) for medical and dental benefits. Additional HPSM benefits include fully paid life, AD&D, STD, and LTD insurance; retirement plan (HPSM contributes equivalent of 10% of annual compensation); holiday and vacation pay; tuition reimbursement plan; onsite fitness center and more. Check out our full benefits package at: https://www.hpsm.org/abouthpsm/employment-opportunities.aspx (Under Employee Benefits Tab)

Application Process: To apply, submit a resume and cover letter with salary expectations to: Health Plan of San Mateo, Human Resources Department, 801 Gateway Blvd., Suite 100, South San Francisco, CA 94080 or via email: careers@hpsm.org or via fax: (650) 616-8039. File by: Continuous until filled. EOE

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