Vice President, Pharmacy Clinical & Specialty Strategies

November 13

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AffirmedRx, a Public Benefit Corporation

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Healthcare Insurance

AffirmedRx is a Public Benefit Corporation dedicated to transforming the pharmacy benefit management (PBM) industry. Focused on transparency, patient-centric care, and innovative solutions, AffirmedRx aims to overcome the complexities and opacity that traditionally plague the PBM sector. By empowering individuals and organizations, the company provides clarity and unwavering support in navigating pharmacy benefits. AffirmedRx stands for integrity and partnership, striving to offer a healthier and more informed pharmacy benefits experience while boldly tackling the rising costs of healthcare and pharmaceuticals.

11 - 50 employees

⚕️ Healthcare Insurance

📋 Description

• Oversee teams creating and maintaining comprehensive formularies ensuring alignment with organizational goals and regulatory requirements • Ensure highest level of cross-functional collaboration to implement formulary changes seamlessly • Guide specialty pharmacy strategy, including pipeline forecasting, biosimilar adoption, and high-cost drug management • Provide thought leadership and expertise across Clinical regulatory compliance requirements in support of URAC and Quality Management initiatives • Remain abreast of industry trends, emerging therapies • Oversee development of drug coverage policies, prior authorization criteria, and utilization management protocols • Lead teams that manage the Pharmacy and Therapeutics committee meetings • Ensure materials created for Pharmacy and Therapeutics committee meetings are aligned with clinical guidelines and membership needs • Collaborate extensively with cross-functional teams to implement and monitor prior authorization protocols effectively • Support new Business Development activity, interfacing with current and prospective clients, providing clinical expertise and guidance • Lead initiatives to improve member outcomes and reduce total cost of care through innovative pharmacy programs • Build, lead, and inspire clinical teams comprised of Prior Authorizations, Clinical Operations, Formulary Strategies, and Medication Therapy Management fostering a collaborative and dynamic culture • Ensure accuracy and efficiency in formulary input and maintenance within the management system, holding the team to high standards of performance and precision • Utilize deep industry knowledge to influence and guide the strategic direction of formulary management, utilization management, and related initiatives • Manage strategic clinical relationships with key partners in the Pharmacy Benefits Management industry inclusive of vendor relationships and rebate aggregators • Leverage your experience in Managed Care, PBM or Clinical Pharmacy to navigate industry challenges, drive innovation, and shape the organization’s approach to formulary strategy • Provide Executive level Clinical expertise and client support to new business development opportunities in collaboration with the AffirmedRx Sales team inclusive of finalist meetings and contracting requirements

🎯 Requirements

• PharmD required with an active and unrestricted Pharmacist license, not state specific • 12-15+ years of industry experience in Managed Care, PBM, or Clinical Pharmacy • Demonstrated success in leadership roles, preferably in formulary development and management at a strategic level • Expertise in pharmacy benefit design, drug utilization management, and healthcare regulations • Strong strategic and analytical mindset, with the ability to translate complex data into actionable strategies • Exceptional leadership, communication, and relationship-building skills • A proactive, solution-oriented approach, paired with emotional intelligence, curiosity, and adaptability • Proven ability to collaborate effectively across functions, both internally and externally • In-depth understanding of pharmaceuticals, therapeutic categories, and evolving healthcare trends • Willingness to travel as needed (10%-20%)

🏖️ Benefits

• To impact industry change in the pharmacy benefits management space, while delivering the highest quality patient outcomes • To work in a culture where people thrive because when OUR team thrives, OUR business thrives • Competitive compensation, including equity, with health, dental, vision and other benefits