Senior Director, Clinical Service

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

📋 Description

• Offer professional insights to APS personnel and clients regarding the clinical significance of medications and drug categories to payers, as well as their management and perception.

• Provide drug information expertise to staff and clients across various therapeutic domains, including ultra-orphan, orphan, and non-orphan disease conditions.

• Execute drug information and clinical/non-clinical investigations into payer attitudes and management of new pharmaceuticals and indications.

• Counsel on payer justifications and strategies for prior authorizations, step-therapy criteria, and other coverage regulations.

• Create Word documents, PowerPoint presentations, and additional materials focused on commercial feasibility, competition, and anticipated payer coverage practices.

• Organize, carry out, and summarize payer research initiatives.

• Plan, design, and lead virtual and in-person payer advisory boards.

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

• Engage with existing and potential clients to bolster business development efforts.

• Aid in drafting statements of work and participate in client presentations to secure new business opportunities.

• Track market trends in clinical drug usage and payer formulary and coverage management.

• Collaborate with the Chief Clinical Officer, VP of Clinical Services, APS team, Nexus, and associated Lockwood companies.

• Oversee clinical team members and freelance consultants as required.

• Support the planning and execution of APS annual seminars.

• Perform additional related tasks as necessary.

⛳️ Requirements

• Pharm. D degree or equivalent, such as a BS in pharmacy with advanced qualifications.

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

• In-depth knowledge of current payer organizations and the regulatory landscape for payers in Commercial and Medicare sectors.

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

• Proven experience in managing individuals and teams.

• Familiarity with Commercial and Medicare lines of business; experience in Medicaid is a plus but not mandatory.

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

• Experience with P&T committee processes.

• Exceptional written and verbal communication abilities.

• Commitment to continuous learning and personal development.

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

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

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

🏝️ Benefits

• Competitive salary and comprehensive benefits package.

• Opportunities for professional development and continuing education.

• Collaborative and supportive work environment.

• Flexible work arrangements available.