Vice President - Pharmacy Health Plan Administration

Leadership (Non-Clinical)

The Vice President, Pharmacy Health Plan Administration, leads pharmacy strategy across Health Alliance Plan (HAP) to ensure cost-effective, high-quality drug benefit programs for all covered lives. This executive role provides enterprise leadership in partnership with the Chief Pharmacy Officer, working across Henry Ford Health and HAP to align innovative pharmacy solutions with clinical excellence, affordability, and patient-centered care.

The Vice President is accountable for transforming pharmacy benefit programs from traditional models to high-value, patient-centered solutions. This leader will shape HAP's pharmacy benefit design, utilization management, PBM relationships, and formulary strategy to improve outcomes, optimize drug spend, and create a more integrated experience for members and providers. With a focus on innovation, collaboration, and performance, the Vice President will play a pivotal role in advancing Henry Ford Health's High-Value Pharmacy Enterprise.

The Vice President Pharmacy Health Plan Administration reports directly to the Chief Pharmacy Officer. This role also reports indirectly to the HAP Medical Director.

PRINCIPLE DUTIES AND RESPONSIBILITIES :

• Oversees all aspects of health plan drug management including strategy development, contracting, rebate management, provider relations, utilization management, data and reporting, and appropriateness of drug therapy in a single structure for HAP.
• Serves as the primary business owner of the health plan's PBM and other pharmacy-related strategic vendors. This includes leading evaluation and selection of new pharmacy vendors; contract negotiation and oversight of the vendor contract; and evaluation of vendor performance.
• Oversees the development and administration of HAP pharmaceutical budgets, contract administration, rebate programs, and incentive programs for medical and pharmaceutical providers for system-wide pharmaceutical expenditures.
• Monitors, evaluates, and presents HAP pharmacy data including reporting of trends for drug utilization, drug costs, and quality metrics. Develops and recommends actionable strategies that promote cost-effective therapy and quality of care for members.
• Provides leadership and staff support for the HAP Pharmacy and Therapeutics Committee and oversees the development and implementation of the health plan's formulary, clinical, and quality improvement programs.
• Assures that drug therapy policies and initiatives are implemented through the utilization management infrastructure with a significant emphasis on coordination with HFMG Medication Management Committee.
• Analyzes and makes recommendations to the HAP Benefits Advisory Committee regarding pharmacy benefit design issues, in conjunction with the HAP Medical Director. Serves as a subject matter expert for clients' Part D and Part B drug benefit designs as part of the annual CMS bid process. Ensures compliance with all CMS, State Medicaid Program, and NCQA pharmacy related regulations and reporting requirements.
• Works with key stakeholders to develop innovative programs and services, including but not limited to Sales and Marketing, Finance, Quality Improvement, and Clinical Services.
• Provides direction and input to cross-functional teams across the High-Value Pharmacy Enterprise (HVPE) to inform product development and innovation. Provides health plan pharmacy subject matter expertise and guidance regarding benefit design and regulatory requirements to ensure efficient pharmacy and medical benefit drug spend and clinical outcomes.
• Responsible for hiring, coaching, managing, and evaluating personnel dedicated to the above functions.
• Provides oversight and program direction for educational programs for physicians, pharmacists, and patients to promote safe, effective and cost-effective drug therapy and to prevent drug-related problems.
• Participates in the training and mentorship of pharmacists, students, residents and fellows within HAP and the HVPE.
• Ensures and promotes customer service and total quality management.
• Serves in additional capacities and responsibilities as outlined by the CPO and to represent the CPO in their absence as assigned by the CPO.

EDUCATION / EXPERIENCE REQUIRED :

CERTIFICATIONS / LICENSURES REQUIRED :