Director of Pharmacy Services

About the role

The Director of Pharmacy Services will lead the strategic pharmacy function for Cascade Comprehensive Care, Inc., a Medicaid‑focused health plan serving roughly 27,000 members in Oregon. Reporting to senior leadership, the Director will shape pharmacy benefit design, oversee claims processing, and drive cost‑containment initiatives across a diverse network of pharmacy partners.

Key responsibilities

• Develop and manage the pharmacy benefit design, ensuring alignment with population health goals.
• Oversee claims adjudication, prior‑authorization workflows, and utilization management programs.
• Negotiate and manage contracts with Pharmacy Benefit Managers (PBMs) and retail pharmacy networks.
• Lead formulary development, clinical review, and evidence‑based medication management.
• Collaborate with providers, tribal pharmacies, and community partners to improve access and clinical outcomes.
• Analyze pharmacy data to identify cost‑saving opportunities and monitor performance metrics.

Required profile

• Extensive experience in pharmacy benefit management, preferably within a Medicaid or public‑health setting.
• Proven leadership ability to influence cross‑functional teams and external partners.
• Strong analytical mindset with experience interpreting pharmacy utilization data.
• Excellent communication skills to convey complex pharmacy concepts to stakeholders.

Required skills

• Formulary development
• Utilization management
• Claims adjudication
• Prior authorization management
• PBM contracting and relationship management