Sr. Director, Clinical Solutions & Pharmacy Strategy

Clarity on the Role:

The Sr. Director, Clinical Solutions and Pharmacy Strategy is accountable for the operational execution and performance management of approved pharmacy and clinical specialty programs across Wellvana's value-based care network. Working in close partnership with executive leadership, internal teams, and external partners, this leader deploys approved programs, integrates vendors into operational workflows, and ensures consistent execution across partners and markets — translating data-driven insights into scalable execution plans that support clinical performance and contract outcomes.

Central to this role is the execution of approved pharmacy performance frameworks, translating program design into operational infrastructure that supports medication adherence, therapy utilization, and cost optimization across complex treatment pathways. Following vendor approval and contracting, the Senior Director assumes full operational ownership of the vendor relationship, overseeing performance management, issue escalation, and renewal readiness reporting to ensure consistent, sustainable program value.

What's Expected:

Vendor Partnerships

• During the vendor evaluation process, provide subject matter expertise to clinical strategy and executive leaders on implementation requirements, operational workflows, technology integration, and care team enablement — ensuring vendor-delivered solutions can be operationalized efficiently and effectively.
• Lead operational due diligence during RFP processes to assess alignment with Wellvana's operational and partner needs.
• Upon vendor selection and approval, own the implementation readiness assessment and deployment plan, overseeing enterprise-wide integration and scaling across multiple partner organizations.
• Lead ongoing lifecycle management of external vendors and specialty solution partners, establish performance management frameworks, reporting structures, and accountability metrics to ensure programs achieve defined clinical and financial outcomes.
• Partner with analytics, operations, and clinical teams to continuously evaluate vendor performance and optimize program impact.

Pharmacy Performance and Operations

• Serve as the operational owner for clinical and pharmacy program rollout, issue resolution, and ongoing performance optimization, ensuring consistent execution across partners and markets.
• Lead vendor implementation, onboarding, and performance management following executive approval.
• Translate claims, clinical, and utilization data into execution plans that operationalize value-based performance objectives and improve cost performance across Wellvana's partner network.
• Execute approved initiatives to reduce total cost of care associated with specialty medications, complex therapies, and high-cost treatment pathways, including appropriate utilization of biologics, specialty therapies, and infusions.
• Maintain enterprise KPIs, reporting frameworks, and performance dashboards to monitor medication adherence, therapy utilization, and medication cost trends.
• Support HEDIS medication measure initiatives and medication adherence performance in collaboration with the Quality team.
• Provide medication-related guidance to internal teams — including clinical consultants, care management, and quality — on medication adherence improvement, polypharmacy reduction, and medication optimization for high-risk populations.
• In coordination with clinical strategy and partner success, support pharmacy performance discussions with clinical leaders and partner organizations.

What’s Required:

• Integrity: The right way is the only way. 
• Dependability: You do what you say you’re going to do. 
• Advocacy: You fight for the best possible outcome for providers and their patients. 
• Clarity: You make it all understandable. 

Education: 

•  PharmD required
• MBA, MPH, MHA, or other relevant advanced degree strongly preferred

Years of Related Experience: 

• 8+ years of healthcare experience in pharmacy leadership, clinical program operations, or value-based care environments, with 4+ years leading enterprise programs or multidisciplinary teams
• Demonstrated success operationalizing and scaling clinical initiatives that improve medication-related cost of care and clinical outcomes
• Proven experience supporting MSSP/ACO REACH, Medicare Advantage, or other risk-bearing value-based care models

Skills/Competencies/Behaviors: 

• Deep expertise in CMS Star Ratings, HEDIS medication adherence measures, and quality performance programs, with a strong understanding of value-based care economics and risk-based contract performance
• Comprehensive pharmacy knowledge including specialty drug management, biologics, medication therapy management, polypharmacy, and the clinical and financial drivers of medication-related cost of care across complex patient populations
• Advanced ability to translate claims and clinical data into operationally actionable initiatives, in alignment with executive leadership direction
• Proven success leading cross-functional initiatives, driving organizational change, and delivering results through strong operational execution
• Executive-level communication skills with demonstrated ability to present effectively to senior leadership and board-level stakeholders