VP Pharmacy Services

GuideWell Source

. Serve as the senior-most pharmacy executive and trusted pharmacy advisor to executive leadership and the Board .

Posted 11/11/2026full-timeJacksonville • Florida • United StatesLeadWebsite

Core Competencies

Role fit

Core Competencies

Use this summary to align your resume positioning with the role.

Demonstrates extensive leadership in pharmacy operations, strategic planning, and financial management within Commercial and Medicare lines of business. Proven ability to drive pharmacy innovation, manage vendor performance, and enhance Medicare Part D Star Ratings through effective clinical programs and stakeholder collaboration.

Highest-signal resume keywords

Pharmacy Operations LeadershipMedicare Part D StrategyPBM Contract NegotiationClinical Pharmacy Program ManagementFinancial Accountability in Pharmacy

ATS Keywords

Tailor your resume

Applicant Tracking System Keywords

Tip: use these terms in your resume and cover letter to boost ATS matches.

Hard Skills

Pharmacy Cost ManagementMedication Therapy ManagementClaims Payment AccuracyFormulary AdministrationData AnalyticsTrend ForecastingBudgeting and Financial PlanningRegulatory ComplianceSpecialty Pharmacy ManagementPharmacy Benefit Design

Soft Skills

Exceptional Communication SkillsCollaborative Relationship BuildingExecutive PresenceLeadership of Cross-Functional TeamsStrategic Partnership Development

Tools & Technologies

Healthcare AnalyticsPharmacy Management SystemsData Automation ToolsPerformance Management ScorecardsDigital Health Solutions

Certifications & Qualifications

Doctor of Pharmacy (PharmD)Florida Pharmacy License

Industry Keywords

Health CareHealth PlanPharmacy Benefit Manager (PBM)Managed CareMedicare AdvantageCommercial PharmacyPharmacy RegulationsClinical IntegrationValue-Based AgreementsMedication Safety

About the role

Key responsibilities & impact

Serve as the senior-most pharmacy executive and trusted pharmacy advisor to executive leadership and the Board
Report to the Chief Operating Officer, Health Services
Set the enterprise pharmacy vision and multi-year strategy for Commercial and Medicare lines of business
Lead strategic, operational, and financial accountability for Commercial, Medicare, and specialty pharmacy programs
Own pharmacy cost of care, trend forecasting, multi-billion-dollar pharmacy spend, net-cost and rebate targets, and annual savings targets
Lead annual goals, budgets, and financial planning
Monitor pharmacy cost and trend to identify improvement and savings opportunities
Direct PBM strategy and governance, including RFPs, market checks, contract negotiations, pricing, rebates, guarantees, transparency, audit rights, and performance management
Oversee PBM and pharmacy vendors, scorecards, contractual performance, claims pricing accuracy, audit closure, rebate attainment, service levels, and financial remedies
Lead pharmacy operations across formulary and clinical policy administration, coverage determinations and appeals, medical-benefit drug management, dispensing channels, claims payment accuracy, and rebate reconciliation
Lead clinical pharmacy programs including adherence, Medication Therapy Management, medication safety, and prescriber engagement
Set formulary, benefit design, and clinical pharmacy program strategy and oversee the Pharmacy and Therapeutics process
Lead specialty drug strategy across pharmacy and medical benefits, including site-of-care, biosimilars, specialty networks, GLP-1s, and cell and gene therapies
Direct Medicare Part D strategy and operations, including bid development, formulary and network adequacy, Medication Therapy Management, and Inflation Reduction Act readiness
Own Part D Star Ratings performance with a goal of 4.5 stars or higher
Integrate Commercial and Medicare pharmacy programs with medical strategy to reduce total cost of care and improve quality
Build pharmacy affordability initiatives and validate savings with Healthcare Economics, Analytics, and Finance
Lead pharmacy innovation, value-based agreements, digital and point-of-care solutions, alternative sourcing, and pricing models
Partner with Product and Actuary on Commercial and Medicare pharmacy offerings
Support targeted ASO efforts and membership growth initiatives
Build pharmacy performance reporting, forecasting, and drug trend analytics
Establish pharmacy operations and clinical KPI scorecards
Apply data, automation, and AI to improve turnaround, outcomes, and efficiency
Lead transformation of Commercial, Medicare, and specialty pharmacy
Represent Florida Blue and Health Care Services on pharmacy and regulatory matters with BCBSA, peer Blue plans, manufacturers, and industry coalitions
Lead compliance, audit readiness, reporting, risk management, and controls for Commercial and Medicare pharmacy regulations
Support Health Care Services strategic partnerships and Healthcare Solutions initiatives
Develop partnerships with Sales/Marketing, Compliance, Medical Operations, Care Management, Service Organization, Network, Product, and Legal
Lead diverse, multidisciplinary, cross-functional teams
Oversee pharmacy-related committees, enabling technologies, pharmacy and medical policies, clinical integration, and operational excellence

Requirements

What you’ll need

Doctor of Pharmacy (PharmD) or related PhD or additional equivalent senior executive experience considered
15+ years of progressive related work experience in health care, health plan, or PBM leadership
Health Plan/PBM senior leadership
Executive leadership of enterprise pharmacy operations
10+ years of progressive management experience, including leading managers and senior leaders
Current Florida pharmacy license or ability to obtain
Deep knowledge of the health care and insurance industry and managed care products, benefits, and programs, including Commercial and Medicare
Exceptional verbal and written communication skills, including executive and Board-level presentation
Proven record of delivering measurable pharmacy cost, quality, and member experience results at enterprise scale
Ability to build productive, collaborative working relationships with key internal and external stakeholders
Knowledge and application of the Florida Blue Management System
Knowledge and application of clinical pharmacy, Florida pharmacy law, and prescription drug services in Florida
Success improving Medicare Part D Star Ratings, including medication adherence, Medication Therapy Management, and medication safety measures
Experience leading PBM RFPs and negotiating PBM and specialty pharmacy contracts, including pricing, guarantees, and rebates
Experience managing specialty drug trends and specialty pharmacy models, including carve-out or multi-vendor arrangements
Experience overseeing pharmacy operations and vendor performance at scale, including prior authorization, claims accuracy, and rebate management
Preferred: MBA, MHA, or comparable advanced degree
Preferred: prior experience leading pharmacy at a Blue plan or comparable health plan
Preferred: direct experience with Medicare Part D and Medicare Advantage pharmacy, including bid development
Preferred: experience leading a PBM transition or specialty pharmacy carve-out and negotiating manufacturer value-based agreements
Preferred: executive presence and experience presenting to senior executives and Board
Must be able to travel to multiple locations for meetings, events, and conferences

Benefits

Comp & perks

Medical, dental, vision, life and global travel health insurance
Life insurance
Short- and long-term disability programs
Leave programs to support personal circumstances
Retirement Savings Plan including employer match
Paid time off
Volunteer time off
10 holidays
2 well-being days
Additional voluntary benefits
Comprehensive wellness program
Opportunities for incentive or commission compensation
Annual reviews with pay for performance considerations for base pay increases