Director, Finance and Business Intelligence

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

📋 Description

• Monitor, manage, and report on performance and cost guarantees, focusing on Net PMPM and operational efficiency.

• Evaluate pharmacy cost drivers and identify trends that influence overall expenses and profit margins.

• Collaborate with stakeholders to implement strategies for cost containment and performance enhancement.

• Ensure that financial outcomes are aligned with organizational objectives and contractual obligations.

• Analyze network pricing, pharmacy claims data, and performance trends at the customer level.

• Deliver actionable insights that facilitate data-driven decision-making throughout the organization.

• Establish and manage comprehensive rebate processes, including forecasting, tracking, and reporting.

• Guarantee accurate reconciliation of rebate accruals with pharmacy claims data.

• Oversee customer payments while maintaining robust internal controls to ensure compliance and precision.

• Assist pricing and underwriting teams by providing real-time financial and operational insights.

• Develop and sustain advanced analytics to foster efficiency and initiatives that create value.

• Work in conjunction with operations, IT, and clinical teams to optimize resource allocation.

• Offer strategic financial counsel to boost PBM performance and support long-term growth strategies.

⛳️ Requirements

• Bachelor’s Degree in Finance, Accounting, Business Administration, or a related discipline.

• Over 10 years of experience in finance, analytics, or pricing/underwriting roles within the Pharmacy Benefit Management sector or a similar industry.

• Proficiency in claims analytics, rebate modeling, and formulary management.

• Strong grasp of pharmacy network economics, PBM contracting, and regulatory compliance.

• Advanced skills in analytical tools and platforms (e.g., SQL, SAS, Tableau) for analyzing claims and rebate data.

• Demonstrated success in providing actionable insights and backing high-impact initiatives in PBM settings.

• Comfortable working in a dynamic, fast-paced environment without established processes.

• Proven capability to convert complex data into clear business recommendations and communicate effectively at the executive level.

🏝️ Benefits

• Competitive salary, including health, dental, vision, and additional benefits.

• Opportunity to drive industry change within the pharmacy benefits management field while ensuring the highest quality patient outcomes.

• Enjoy a culture where individuals flourish, because when OUR team succeeds, OUR business prospers.