Government Specialty Pharmacy Director
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Job Description
Director providing strategic leadership and oversight for specialty pharmacy benefit serving federal members. Collaborating with executive stakeholders to ensure optimal clinical outcomes and member experience.
Responsibilities:
- Provide strategic leadership and oversight for the specialty pharmacy benefit serving a large federal member population
- Lead the overall administration, operational delivery, regulatory compliance, and program performance
- Serve as the enterprise owner of the specialty pharmacy benefit strategy for the Federal Employee Program
- Build and maintain trusted partnerships with federal program leadership, senior internal stakeholders, and vendor partners
- Lead executive program reviews and strategic discussions, presenting insights on program performance, emerging risks, and opportunities for improvement
- Provide leadership across clinical, operational, financial, analytics, and PBM teams
- Manage high-priority escalations and complex issues
- Provide strategic oversight and governance of the specialty pharmacy benefit
- Guide the planning, implementation, and continuous improvement of specialty pharmacy benefit programs
- Monitor program performance through key operational, clinical, and service metrics
- Ensure the specialty pharmacy program operates in full compliance with federal regulations, contractual obligations, and program governance standards
- Provide strategic oversight of PBM and specialty pharmacy vendor relationships
- Lead cross-functional teams responsible for implementing specialty pharmacy benefit updates, program enhancements, and regulatory changes
- Leverage specialty pharmacy claims data, utilization trends, and operational metrics to evaluate program performance
Requirements:
- Bachelor's Degree in Pharmacy, Health Care Administration, Business or related field; or equivalent experience
- Master's Degree (MBA or PharmD preferred)
- 15+ Years Experience in account management, pharmacy benefit administration, PBM operations, specialty pharmacy, or federal health care program oversight
- Strong understanding of specialty benefit design, utilization management, clinical programs, and PBM operations
- Experience supporting, managing, or administering Federal programs (e.g., Federal Employee Program, TRICARE, VA, DoD, or other federally regulated healthcare benefits)
- Direct experience with the Federal Employee Program (FEP), OPM requirements, or similar federal benefit environments preferred
- Familiarity with specialty pharmacy workflows, prior authorization programs, and limited-distribution networks preferred
- Knowledge of federal regulatory requirements, audit standards, and healthcare program compliance preferred
- Demonstrated ability to manage large, complex accounts with multiple stakeholders
- Excellent communication, presentation, and executive-facing engagement skills
- Ability to interpret and translate pharmacy data into actionable insights
- Experience leading cross-functional projects or program implementations.
Benefits:
- Paid time off
- 11 holidays
- Medical/dental/vision insurance
- Generous 401(k) matching
- Lifestyle spending account
- Annual bonus incentive pay
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