Clinical Director, Payer-Focused Consulting

This is a fully remote position, open to applicants in United States.

📋 Description

• Deliver expert insights to APS and its clients regarding the clinical value of pharmaceuticals to payers and how these will be viewed and managed by them.

• Provide APS and its clients with extensive drug information expertise across various therapeutic areas.

• Perform drug information and additional research to comprehend how payer lines of business will perceive and manage new pharmaceuticals and indications.

• Counsel staff and clients on payer rationales and strategies for Prior Authorizations, step-therapy edits, and other coverage regulations.

• Create Word documents, PowerPoint presentations, and other materials detailing commercial viability, competition, and anticipated payer coverage practices.

• Organize, conduct, and summarize payer research.

• Assist in planning, developing, and moderating both virtual and in-person payer advisory boards.

• Evaluate and enhance client value propositions and preapproval information exchange presentations.

• Engage with both current and potential clients, showcasing APS drug and drug therapy expertise.

• Support with statements of work and participate in client presentations to secure new business opportunities.

• Stay updated on clinical drug-marketplace trends and payer formulary and coverage management practices.

• Collaborate with the APS Chief Clinical Officer and VP of Clinical Services.

• Act as an essential member of the APS, Nexus, and associated company teams.

⛳️ Requirements

• PharmD degree or equivalent, such as a BS in pharmacy with an advanced degree.

• A minimum of 5 to 10 years of experience in a managerial or supervisory drug information role within a payer, such as a health plan or PBM, focusing on formulary development, coverage management, and benefit design.

• In-depth understanding of current payer organizations and the payer regulatory landscape in both Commercial and Medicare sectors.

• Experience in drug information with payers, including the development of drug monographs, class reviews, drug formularies, coverage criteria, appeals criteria, clinical policies, etc.

• Familiarity with Commercial and Medicare lines of business.

• Experience in benefit design, coverage determination, benefit allocation, and coverage review and appeal processes.

• Knowledge of P&T committee processes.

• Exceptional written and verbal communication skills.

• Commitment to lifelong learning and professional development.

• Capability to facilitate and moderate virtual or in-person payer advisory boards and panels.

• Ability to collaborate with and support other clinical and non-clinical experts within APS and other Lockwood companies to collectively achieve company and client goals.

• Strong time management skills with the ability to meet established deadlines.

🏝️ Benefits

• Competitive salary and performance-based incentives.

• Comprehensive health, dental, and vision insurance plans.

• Generous paid time off and holiday schedule.

• Opportunities for ongoing professional development and training.

• A collaborative and supportive work environment.