Vice President, Clinical Pharmacy (PBM)

Job Description

Job Description

The Vice President of Clinical Pharmacy provides hands-on and client facing clinical leadership and expertise in the design and execution of pharmacy benefit management programs, including utilization management, cost containment strategies, and client clinical consulting. Collaborates with and supports internal teams, clients, and the Pharmacy & Therapeutics (P&T) Committee to ensure evidence-based, cost-effective medication use in alignment with FDA guidelines and URAC PBM Standards. Supports client satisfaction, retention, and performance improvement through strategic oversight and hands-on clinical insight.

PRINCIPLE RESPONSIBILITIES include but are not limited to:
• Oversee all aspects of PBM clinical areas, including design and coordination with new and existing rebate and clinical programs , including step therapy, prior authorization, cost containment strategies, and participation in the Pharmacy & Therapeutics Committee as well as management of clinical staff .
• Provide clinical oversight of analysis of therapeutic trends, utilization patterns, and opportunities to improve patient outcomes and manage costs.
• Ensure all programs align with evidence-based medicine, FDA guidelines, URAC PBM Standards, and internal performance improvement requirements .
• Partner with clients to establish clinical goals, deliver recommendations, and present performance reviews that support cost containment and trend management.
• Act as a subject matter expert for clinical discussions, client strategy sessions, and RFP/finalist activities.
• Collaborate with client services, sales, and implementation teams to ensure seamless delivery of clinical programs, client support and sales prospect clinical presentations.
• Support and mentor clinical staff, contributing to knowledge sharing, professional development, and high-quality client deliverables.
• Work across departments to integrate clinical strategies into organizational objectives.
• Monitor emerging therapies, regulatory changes, and PBM trends to inform clinical program design to inform innovation, guide program design, and identify opportunities for potential emulation.
• Contribute to the development of new or enhanced clinical programs and services that strengthen client value.
• Support specialty pharmacy and utilization management initiatives tailored to evolving client needs.
•Lead and contribute to industry thought leadership efforts, including developing clinical insights for publication, participating in media engagements, representing the organization at conferences, and promoting the organization’s clinical value proposition across professional and public channels.

QUALIFICATIONS AND REQUIREMENTS:
▪ Bachelor’s degree in Pharmacy from an accredited college of pharmacy.
▪ Doctor of Pharmacy (PharmD) preferred; MBA or other advanced degree a plus.
▪ Minimum eight years of pharmacy practice experience (PBM, managed care, retail, or hospital) required, focused managed care experience preferred
▪ Experience collaborating with clients and internal teams on clinical program design and delivery.
▪ Strong clinical acumen with the ability to interpret and communicate healthcare trends.
▪ Excellent staff management, communication, presentation, and client relationship skills.
▪ Proven time management and organizational skills to manage multiple priorities effectively.
▪ Adaptable, collaborative, and solution-oriented, with willingness to travel as needed.

PHYSICAL DEMANDS
Requires sitting, standing and occasional light lifting.

ProCare Rx will never ask for a financial commitment from an applicant, as part of our recruitment process. All interviews are conducted in-person OR through video conference invitations from official company emails. For inquiries, please contact our official recruitment team at View email address on ziprecruiter.com.

ProCare Rx is an Equal Opportunity Employer.