Director, Pharmacy Clinical Operations Emory Health Plan

Emory University is a leading research university that fosters excellence and attracts world-class talent to innovate today and prepare leaders for the future. We welcome candidates who can contribute to the excellence of our academic community.

Director of Pharmacy Clinical Operations - Emory Health Plan is responsible for driving clinical excellence evidence-based medication management and stewardship of pharmacy spend across enterprise plans membership.

KEY RESPONSIBILITIES:

• Leads medication use evaluations (MUEs) prepares clinical materials for the Pharmacy & Therapeutics (P&T) Committee develops strategies that improve quality outcomes and serves as a liaison to Emory physicians service lines and clinical leaders.
• Supports both clinical and financial performance by identifying opportunities for optimized utilization implementing evidence-based initiatives and advancing EHPs integrated care model.
• Leads Medication Use Evaluations (MUEs) across high-cost high-impact therapeutic categories (e.g. specialty chronic disease oncology immunology).
• Identifies medication-related trends quality gaps and opportunities for improved clinical management.
• Develops clinical strategies that enhance outcomes reduce unwarranted variation and promote safe cost-effective prescribing.
• Evaluates new therapies guidelines and pipeline agents to inform proactive benefit and policy decisions.
• Prepares reviews and presents clinical materials for the Pharmacy & Therapeutics Committee including drug monographs comparative evidence reviews formulary recommendations and safety updates.
• Ensures clinical recommendations reflect best available evidence Emory clinical pathway alignment and financial stewardship considerations.
• Maintains documentation committee records and formulary reference materials.
• Partners with UM teams to design and refine prior authorization criteria step therapy pathways and clinical edits.
• Monitors utilization patterns adherence trends prescribing behaviors and opportunities for quality improvement.
• Leads development of clinical care pathways disease state strategies and population health pharmacy programs (e.g. cardiometabolic immunology rare disease).
• Supports HEDIS STARs and internal quality initiatives through pharmacy-focused interventions.
• Serves as the primary pharmacy liaison with Emory physicians clinical service lines ambulatory care teams and population health leaders.
• Collaboratively develops evidence-based approaches to improve prescribing optimize specialty drug use and support value-based care initiatives.
• Provides clinical guidance to EHP leadership including interpretation of therapeutic evidence quality metrics and medication policy impacts.
• Identifies opportunities to reduce avoidable pharmacy and medical spend while maintaining or improving clinical outcomes.
• Conducts cost-effectiveness analyses total cost of care reviews and ROI assessments for pharmacy programs.
• Collaborates with analytics and finance partners to track specialty drug trend high-cost member impact and budget performance.
• Supports integration of medical pharmacy benefit strategies to improve care alignment and financial sustainability.
• Partners closely with PBM teams Emory Specialty Pharmacy ambulatory pharmacy operations care management and population health teams. Supports implementation of new benefit designs formulary changes and clinical programs.
• Contributes to EHP governance committees physician advisory groups and enterprise clinical initiatives.

MINIMUM QUALIFICATIONS:

• Doctor of Pharmacy (PharmD) from an accredited School of Pharmacy.
• At least 5 years of clinical pharmacy managed care or health system experience and 5 years of leadership experience.
• Strong knowledge of drug therapy formulary management evidence evaluation and population health principles.
• Experience preparing drug monographs MUEs or P&T materials.
• Ability to engage effectively with physicians clinical leaders and multidisciplinary teams.
• Strong analytical and communication skills.

PREFERRED QUALIFICATIONS:

• Completion of PGY1 residency preferred in managed care or PGY-2 in ambulatory care population health or pharmacotherapy.
• Prior experience within a health plan PBM IDN or specialty pharmacy setting.
• Experience with utilization management criteria outcomes measurement or quality improvement programs.
• Familiarity with medical pharmacy benefit integration and specialty drug management.

NOTE: Position tasks are generally required to be performed in-person at an Emory University location. Remote work from home day options may be granted at department discretion. Emory reserves the right to change remote work status with notice to employee.

Emory is an equal opportunity employer and qualified applicants will receive consideration for employment without regard to race color religion sex national origin disability protected veteran status or other characteristics protected by state or federal law. Emory University does not discriminate in admissions educational programs or employment including recruitment hiring promotions transfers discipline terminations wage and salary administration benefits and training. Students faculty and staff are assured of participation in university programs and in the use of facilities without such discrimination. Emory University complies with Section 503 of the Rehabilitation Act of 1973 the Vietnam Era Veterans Readjustment Assistance Act and applicable executive orders federal and state regulations regarding nondiscrimination equal opportunity and affirmative action (for protected veterans and individuals with disabilities). Inquiries regarding this policy should be directed to the Emory University Department of Equity and Civil Rights Compliance 201 Dowman Drive Administration Building Atlanta GA 30322. Telephone: (V) (TDD).

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