Vice President - Pharmacy

Vice President, Pharmacy

GEHA (Government Employees Health Association, Inc., pronounced G.E.H.A.) is a nonprofit member association that provides medical and dental benefits to more than two million federal employees and retirees, military retirees and their families. We celebrate diversity and are committed to creating an inclusive environment for all employees.

GEHA has one mission : To empower federal workers to be healthy and well.

Offering one of the largest medical and dental benefit provider networks available to federal employees in the United States, GEHA empowers health and wellness by meeting its members where they are, when they need care. We serve our members with products they value and a personalized customer experience, sustained by a nimble and efficient organization.

The Vice President, Pharmacy is a senior executive leader responsible for setting and executing G.E.H.A's enterprise pharmacy strategy. In partnership with the Chief Medical Officer, this role oversees all aspects of pharmacy operations, benefit management, PBM oversight, pharmacy network strategies, clinical pharmacy programs, and regulatory compliance. Serving as a key member of the clinical executive team, this role is critical to managing pharmacy utilization trends, optimizing the Medical Loss Ratio (MLR), and ensuring integration of pharmacy strategy across population health, utilization management, and quality initiatives for all G.E.H.A products and lines of business. The ideal candidate is a PharmD with deep PBM and managed care experience, strong financial and regulatory acumen, and a proven record of driving innovation, compliance, and outcomes in a payer environment.

Skills

Duties and Responsibilities :

• Define and lead G.E.H.A's pharmacy enterprise strategy in alignment with corporate goals, clinical outcomes, and cost containment initiatives.
• Lead oversight of PBM vendor(s), including contracting, network design, rebate strategy, pricing oversight, and service performance.
• Guide formulary management, drug pipeline forecasting, and cost control initiatives across all products and lines of business.
• Oversee development and implementation of clinical pharmacy programs including prior authorization, adherence support, and medication therapy management.
• Ensure full compliance with OPM, CMS, NCQA, URAC, and other applicable state / federal regulations governing pharmacy benefit management.
• Partner with Medical, Care Management, Behavioral Health, and Clinical Quality to drive integration of pharmacy-related strategic initiatives into population health efforts.
• Collaborate with Product, Legal, Compliance, and Government Affairs teams to ensure pharmacy benefits are designed and administered to meet member and employer needs.
• Serve as the pharmacy subject matter expert on MLR strategy, risk mitigation, and value-based contract modeling.
• Provide executive leadership to a cross-functional team including pharmacists, analysts, and operational professionals.
• Foster a high-performance culture focused on innovation, data-driven decision making, and strategic execution.
• Represent G.E.H.A in external forums, vendor negotiations, and policy advocacy efforts related to pharmacy trends and affordability.

Knowledge, Skills, and Abilities :

Leadership and Team Management :

Regulatory Compliance and Quality Assurance :

Qualifications :

Flexible Work Environment :

Preferred Qualifications :

Work-at-home requirements :

How we value you :

Please note that the salary information is a general guideline only. GEHA considers factors such as (but not limited to) scope and responsibilities of the position, candidate's work experience, education / training, key skills, internal peer equity, as well as, market and business considerations when extending an offer. The annual base salary range for this position is $240,438 - $360,658 USD.

GEHA is an Equal Opportunity Employer, which means we will not discriminate against any individual based on sex, race, color, national origin, disability, religion, age, military status, genetic information, veteran status, pregnancy, marital status, gender identity, and sexual orientation, as well as all other characteristics and qualities protected by federal, state, or local law. GEHA will not discriminate against employees or applicants because they have inquired about, discussed, or disclosed their compensation or the compensation of another employee or applicant. We are committed to creating an inclusive environment for all employees. Our diversity drives innovation deepens connections and strengthens our organization.

GEHA is headquartered in Lee's Summit, Missouri, in the Kansas City area. We recognize the importance of balance and flexibility and offer hybrid and work-from-home options for many of our roles.