Pharmacy Clinical & Quality Programs AVP

About the role

The Pharmacy Clinical & Quality Programs AVP leads the design, implementation, and continuous improvement of key pharmacy initiatives, ensuring regulatory compliance and alignment with population‑health goals. This senior position partners with pharmacy and clinical leadership to drive high‑impact programs such as Medication Therapy Management, Drug Management Programs, and CMS STARS measures.

Key responsibilities

• Oversee implementation and day‑to‑day operations of clinical services, pharmacy utilization, and account‑management programs.
• Manage vendor relationships for MTM, integrated diabetes, specialty pharmacy interventions, and CMS‑related initiatives.
• Ensure all programs meet federal, state, and local regulations as well as NCQA and CMS standards.
• Collaborate with cross‑functional teams to integrate pharmacy programs with broader care‑management and quality‑improvement efforts.
• Monitor performance metrics, quality outcomes, and regulatory compliance; prepare reports and recommendations for senior leadership.
• Represent the pharmacy department in operational meetings, client discussions, and cross‑functional committees.
• Assist in budget planning, resource allocation, and cost‑effective program administration.

Required profile

• Extensive experience in pharmacy clinical program management and quality assurance.
• Strong knowledge of CMS STARS, NCQA, MTM, and related regulatory frameworks.
• Proven ability to lead cross‑functional initiatives and manage vendor partnerships.
• Excellent analytical and reporting skills to drive continuous improvement.

Required skills

What we offer

• Opportunity to shape pharmacy clinical strategy at a senior leadership level.
• Collaborative environment with multidisciplinary teams.
• Competitive compensation and benefits package.