Vice President - Pharmacy

GEHA (Government Employees Health Association, Inc., pronounced G.E.H.A.) is a nonprofit member association that provides medical and dental benefits to more than two million federal employees and retirees, military retirees and their families. We celebrate diversity and are committed to creating an inclusive environment for all employees.

GEHA has one mission: To empower federal workers to be healthy and well.

Offering one of the largest medical and dental benefit provider networks available to federal employees in the United States, GEHA empowers health and wellness by meeting its members where they are, when they need care. We serve our members with products they value and a personalized customer experience, sustained by a nimble and efficient organization.

Duties and Responsibilities:

• Define and lead G.E.H.A's pharmacy enterprise strategy in alignment with corporate goals, clinical outcomes, and cost containment initiatives.
• Lead oversight of PBM vendor(s), including contracting, network design, rebate strategy, pricing oversight, and service performance.
• Guide formulary management, drug pipeline forecasting, and cost control initiatives across all products and lines of business.
• Oversee development and implementation of clinical pharmacy programs including prior authorization, adherence support, and medication therapy management.
• Ensure full compliance with OPM, CMS, NCQA, URAC, and other applicable state/federal regulations governing pharmacy benefit management.
• Partner with Medical, Care Management, Behavioral Health, and Clinical Quality to drive integration of pharmacy-related strategic initiatives into population health efforts.
• Collaborate with Product, Legal, Compliance, and Government Affairs teams to ensure pharmacy benefits are designed and administered to meet member and employer needs.
• Serve as the pharmacy subject matter expert on MLR strategy, risk mitigation, and value-based contract modeling.
• Provide executive leadership to a cross-functional team including pharmacists, analysts, and operational professionals.
• Foster a high-performance culture focused on innovation, data-driven decision making, and strategic execution.
• Represent G.E.H.A in external forums, vendor negotiations, and policy advocacy efforts related to pharmacy trends and affordability.

Knowledge, Skills, and Abilities:

• Deep understanding of pharmacy benefit management structures, specialty drug pipelines, formulary design, and utilization management
• Strategic and operational leadership in a managed care or integrated health plan environment
• Strong financial acumen, including ability to influence pharmacy trends, manage rebates, and support actuarial forecasting.
• Excellent vendor management and negotiation skills
• Strong knowledge of federal and state pharmacy regulations, CMS Part D, EGWP, and FEHB requirements
• Demonstrated success in cross-functional collaboration and enterprise strategy development.
• Excellent verbal and written communication skills to effectively interact with stakeholders and convey complex information in a clear manner.
• The ability to lead through complexity and drive changes in a dynamic healthcare environment.
• Strong analytical, critical thinking, and decision-making capabilities.

Leadership and Team Management

• Provide visionary leadership to the Pharmacy team, setting clear objectives, priorities, and performance expectations.
• Foster a collaborative and high-performance work environment where team members are motivated, engaged, and empowered to contribute their best.
• Mentor and coach team members, supporting their professional growth and skill development in pharmacy design, development, and management.

Regulatory Compliance and Quality Assurance

• Work closely with legal and compliance teams to ensure that Pharmacy adheres to all relevant regulatory and compliance standards.
• Implement rigorous quality assurance processes to ensure that Pharmacy meets the highest standards of safety, security, and reliability.

Qualifications

• Doctor of Pharmacy (PharmD) required.
• 15+ years of relevant pharmacy experience, including at least 5 years in a PBM, health plan, or managed care setting.
• 8+ years of leadership experience.
• Demonstrated experience leading enterprise pharmacy strategy and managing PBM performance.
• Proven success in implementing clinical pharmacy programs and cost containment strategies.
• Experience managing high-performing teams and fostering a culture of accountability, collaboration, and innovation.

Flexible Work Environment

• This position may be hybrid or remote, with occasional travel required for departmental meetings, executive leadership sessions, and board meetings.

Preferred Qualifications

• Experience in government-sponsored programs (e.g., Medicare, Medicaid, EGWP, FEHB, and PSHB)
• Board certification (e.g., BCPS, BCGP)
• Experience with pharmacy informatics, digital therapeutics, or clinical decision support systems
• Familiarity with value-based pharmacy models and risk-based contracting models
• Master's degree in business administration, Public Health, Health Administration, or related field strongly preferred.

Work-at-home requirements

• Must have the ability to provide a non-cellular High Speed Internet Service such as Fiber, DSL, or cable Modems for a home office.
• A minimum standard speed for optimal performance of 30x5 (30mpbs download x 5mpbs upload) is required.
• Latency (ping) response time lower than 80 ms
• Hotspots, satellite and wireless internet service is NOT allowed for this role.
• A dedicated space lacking ongoing interruptions to protect member PHI / HIPAA information

How we value you

• Competitive pay/salary ranges
• Incentive plan
• Health/Vision/Dental benefits effective day one
• 401(k) retirement plan: company match - dollar for dollar up to 4% employee contribution (pretax or Roth options) plus a 6% annual company contribution
• Robust employee well-being program
• Paid Time Off
• Personal Community Enrichment Time
• Company-provided Basic Life and AD&D
• Company-provided Short-Term & Long-Term Disability
• Tuition Assistance Program

Please note that the salary information is a general guideline only. GEHA considers factors such as (but not limited to) scope and responsibilities of the position, candidate's work experience, education/training, key skills, internal peer equity, as well as, market and business considerations when extending an offer.

GEHA is an Equal Opportunity Employer, which means we will not discriminate against any individual based on sex, race, color, national origin, disability, religion, age, military status, genetic information, veteran status, pregnancy, marital status, gender identity, and sexual orientation, as well as all other characteristics and qualities protected by federal, state, or local law. GEHA will not discriminate against employees or applicants because they have inquired about, discussed, or disclosed their compensation or the compensation of another employee or applicant. We are committed to creating an inclusive environment for all employees. Our diversity drives innovation deepens connections and strengthens our organization.

GEHA is headquartered in Lee's Summit, Missouri, in the Kansas City area. We recognize the importance of balance and flexibility and offer hybrid and work-from-home options for many of our roles.