Director, Pharmacy Trend and Pipeline Strategy

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

📋 Description

• Take ownership of enterprise pharmacy trend forecasting and market surveillance to uncover emerging cost drivers and utilization patterns.

• Oversee the drug development pipeline, evaluating the clinical, financial, operational, and formulary implications of new therapies.

• Analyze shifts within therapeutic categories and propose proactive strategies to mitigate potential impacts on client spending.

• Keep track of market trends, access strategies, and industry advancements to identify opportunities for intervention and differentiation.

• Create and manage a multi-year pharmacy trend mitigation roadmap that aligns with organizational objectives.

• Suggest formulary, utilization management, biosimilar, generic, and channel management strategies to tackle emerging cost challenges.

• Assess new-to-market and high-impact pipeline therapies, providing clinical recommendations prior to their launch.

• Collaborate with internal stakeholders to prioritize and execute initiatives aimed at enhancing trend performance and cost management.

• Spearhead the development of AffirmedRx’s biosimilar strategy in partnership with Formulary Strategy and Utilization Management.

• Advise on formulary positioning, utilization management tactics, and conversion strategies to facilitate biosimilar adoption.

• Assist in provider education and monitoring efforts to ensure effective implementation.

• Evaluate formulary and benefit design opportunities that optimize outcomes while managing pharmacy expenditures.

• Act as a key contributor to the Clinical Intelligence Council by assessing trend drivers and prioritizing intervention opportunities.

• Collaborate with Clinical Modeling to produce financial impact assessments and pharmacoeconomic analyses.

• Quantify anticipated trend drivers, savings opportunities, and return on investment for proposed strategies.

• Support enterprise decision-making by providing data-driven clinical and financial insights.

• Serve as the clinical lead for pipeline, trend, biosimilar, and pharmacoeconomic evaluations presented to the Pharmacy & Therapeutics Committee.

• Develop strategic recommendations and clinical content for enterprise and client-facing trend reporting.

• Work together with Specialty, Trade Relations, Population Health, and other stakeholders on channel management initiatives.

• Effectively communicate complex clinical and market insights to executive leadership, clients, and internal business partners.

⛳️ Requirements

• Doctor of Pharmacy (PharmD) degree from an accredited institution.

• Active, unrestricted pharmacist license in the United States.

• 10+ years of experience in managed care, PBM, or health plan pharmacy, with direct experience in pharmacy trend analysis, forecasting, pipeline evaluation, or cost-of-care management.

• Proven experience in identifying, evaluating, and developing strategies to address pharmacy trend drivers, including specialty drug spending, biosimilars, generic launches, pipeline therapies, and utilization management opportunities.

• Strong analytical skills with a background in interpreting pharmacy utilization, trend, and financial data to pinpoint actionable opportunities.

• Experience in developing business cases, financial impact assessments, or pharmacoeconomic analyses to support formulary, utilization management, biosimilar, or trend mitigation decisions.

• In-depth knowledge of formulary management, utilization management strategies, pharmacoeconomics, and specialty pharmacy market dynamics.

• Exceptional quantitative and analytical skills, with the ability to present trend data effectively to clients or executive audiences.

• Familiarity with PBM trend reporting tools and client-facing communication.

• Knowledge of net-cost formulary architecture and rebate-aware formulary strategy.

• Experience in developing pharmacy trend forecasts, market impact models, or cost-of-care projections to guide business or formulary strategy.

• Experience in monitoring FDA pipeline developments and translating clinical, regulatory, and market events into formulary, utilization management, and operational readiness strategies.

🏝️ Benefits

• Opportunity to influence change in the pharmacy benefits management sector while delivering optimal patient outcomes.

• Work in a culture that fosters thriving individuals, recognizing that when OUR team thrives, OUR business flourishes.

• Competitive compensation package, which includes health, dental, vision, and various other benefits.