Health systems across the country are rethinking what pharmacy leadership looks like. The most sought-after roles today go beyond dispensing medications; they center on finance, data analytics, payer relations and technology integration, reflecting pharmacy’s growing role in both clinical and operational strategy.
“At this point, the roles focused on 340B program management and pharmacy finance are in highest demand,” said Majid Tanas, PharmD, vice president of pharmacy services at UCHealth in Aurora, Colo. “Organizations are navigating complex reimbursement landscapes, and these positions require strong analytical capabilities to drive decisions.”
Drug costs and reimbursement rules have grown increasingly complex, and programs such as 340B — which allow eligible hospitals to buy discounted drugs — have become both a financial lifeline and a regulatory challenge. Leaders say pharmacists who can model revenue, forecast costs and ensure compliance will be important in managing these pressures. Those who understand both the clinical and economic implications of a decision are especially valuable as pharmacy becomes more integrated with health system strategy.
Amy Dickson, PharmD, regional chief pharmacy officer for Columbus, Ohio-based Mount Carmel Health System, said the most critical pharmacy leadership roles now blend clinical expertise with enterprise strategy, overseeing high-cost therapies, managing payer relationships and leveraging technology to expand patient access.
“As health systems adapt to rising costs and shifting care models, the chief pharmacy officer has become a cornerstone of organizational strategy,” she said. “These leaders are cultivating teams that sustain innovation, strengthen financial performance and advance population health.”
For many systems, this shift is changing the pipeline of who rises through the ranks. Pharmacy leaders who once specialized in clinical or operational domains are now expected to collaborate with finance, strategy and digital health teams — a combination that demands business fluency as much as clinical credibility.
“As healthcare continues to evolve, there’s a significant push toward integrating pharmacy services more deeply into patient care teams,” said Nilesh Desai, chief pharmacy officer at Louisville, Ky.-based Baptist Health System. “We need to develop leaders for the future on all fronts.”
At the University of Utah in Salt Lake City, Chief Pharmacy Officer Kavish Choudhary, PharmD, said health systems are also expanding into new territory: payer relations.
“Organizations with retail pharmacies already have staff involved in PBM negotiations,” he said. “But historically, we’ve had limited roles with medical-benefit payers. There’s real opportunity for pharmacists and technicians to lead in areas like contract negotiations, authorization management and risk mitigation.”
As hospitals take on more risk under value-based payment models, Dr. Choudhary sees these roles as critical to protecting access and revenue.
For UCLA Health Chief of Pharmacy Deepak Sisodiya, PharmD, the defining skill of the modern pharmacy leader is not a technical one; it’s adaptability.
“Leaders must now have the ability to navigate complexity and effectively lead people through change,” he said.
Pharmacy departments are being asked to modernize systems, redesign workflows and integrate automation, all while maintaining patient safety and staff morale. The leaders who can balance those demands, Dr. Sisodiya said, are the ones shaping what the future of hospital pharmacy will look like.
These shifts point to a broader redefinition of the pharmacy profession, one that prizes financial fluency, operational agility and leadership in an evolving healthcare landscape.
“Pharmacy is no longer just about dispensing medications,” Dr. Dickson said. “It’s about building systems that make healthcare work better.”
