Pharmacy Director, Health Plan

Job Description

Location: Indianapolis, IN

We are seeking a Pharmacy Director, Health Plan to serve as the enterprise pharmacy authority across all lines of business for a regional health plan. This position is a full-time, direct hire opportunity based in Indianapolis, IN with hybrid flexibility.

This role is best aligned for a managed care pharmacy leader ready to own formulary strategy, utilization management, and PBM performance for an entire plan. You will chair the P&T Committee, set specialty and biosimilar strategy, hold the PBM accountable on contract and rebate performance, and partner with Finance and Actuarial on trend and bid development. The ideal candidate has run a P&T committee, negotiated with a PBM, and can defend a formulary decision to clinicians, regulators, and the CFO with equal credibility.

Responsibilities:

• Serve as the enterprise pharmacy authority across all lines of business, ensuring competitive and compliant benefit designs
• Lead the Pharmacy and Therapeutics Committee, directing evidence-based formulary management and clinical monograph development
• Oversee drug utilization management including prior authorization, step therapy, and quantity limit protocols
• Direct specialty pharmacy strategy including site-of-care optimization, distribution management, and biosimilar conversion
• Manage PBM vendor relationships including contract monitoring, rebate reconciliation, and RFP negotiations
• Design and evaluate clinical programs targeting Stars measures, HEDIS gaps, and medication therapy management quality
• Monitor emerging drug trends including cell and gene therapies, GLP-1 agents, and oncology innovations
• Ensure compliance with CMS Medicare Part D requirements, Medicaid PDL alignment, and NCQA accreditation standards
• Partner with Finance and Actuarial teams on pharmacy trend reporting and annual bid development
• Build and develop the clinical pharmacy team, including hiring, coaching, and performance management

Qualifications:

• PharmD from an ACPE-accredited institution required
• PGY1 or PGY2 residency in managed care, ambulatory care, or health system pharmacy required
• Active, unrestricted pharmacist license required; Indiana licensure required within 90 days of hire
• BCPS, BCACP, or comparable board certification preferred; non-certified candidates expected to complete certification within 12 months
• Minimum of 7 years of pharmacy experience required, including 4 years in a health plan, managed care, or PBM setting and 3 years in a leadership role
• Deep working knowledge of Medicare Part D, CMS formulary requirements, Medicaid PDL, and commercial benefit design
• Demonstrated experience leading P&T committees, building clinical utilization management programs, and presenting evidence-based drug policy recommendations
• Strong executive communication skills with the ability to influence clinical, financial, and regulatory stakeholders

Schedule:

• Full-time position, Monday through Friday
• On-site in Indianapolis, IN with some hybrid flexibility
• Standard business hours

Salary Range: The salary range for this position is approximately $170,000 – $205,000 annually ($81.73 – $98.56 per hour), based on experience and qualifications.

Interview Process:

Selected candidates will participate in a multi-step interview process, including an initial screening with TalentLNX followed by interviews with senior leadership.

Equal Opportunity Employer: TalentLNX is committed to equal employment opportunity and a diverse, inclusive workforce. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, or veteran status.