Director, Pharmacy Trend and Pipeline Strategy

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🔥 0 minutes ago

🇺🇸 United States – Remote

⏰ Full Time

🔴 Lead

💊 Pharmacist

👻 Ghost score 16%

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AffirmedRx, a Public Benefit Corporation

WebsiteLinkedInAll Job Openings

11 - 50 employees

🏥 Healthcare

⚕️ Healthcare Insurance

Healthcare • 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.

📋 Description

• Own enterprise pharmacy trend forecasting and market surveillance to identify emerging cost drivers and utilization patterns • Maintain oversight of the drug development pipeline, assessing clinical, financial, operational, and formulary impacts of new therapies • Evaluate therapeutic category shifts and recommend proactive strategies before they materially impact client spend • Monitor market trends, access strategies, and industry developments to identify opportunities for intervention and differentiation • Develop and maintain a multi-year pharmacy trend mitigation roadmap aligned with organizational goals • Recommend formulary, utilization management, biosimilar, generic, and channel management strategies to address emerging cost pressures • Evaluate new-to-market and high-impact pipeline therapies and provide clinical recommendations prior to launch • Partner with internal stakeholders to prioritize and implement initiatives that improve trend performance and cost management • Lead the development of AffirmedRx’s biosimilar strategy in collaboration with Formulary Strategy and Utilization Management • Recommend formulary positioning, utilization management approaches, and conversion strategies to support biosimilar adoption • Support provider education and adoption monitoring efforts to ensure successful implementation • Assess formulary and benefit design opportunities that optimize outcomes while managing pharmacy spend • Serve as a key contributor to the Clinical Intelligence Council by evaluating trend drivers and prioritizing intervention opportunities • Partner with Clinical Modeling to develop financial impact assessments and pharmacoeconomic analyses • Quantify projected trend drivers, savings opportunities, and return on investment for proposed strategies • Support enterprise decision-making through 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 • Collaborate with Specialty, Trade Relations, Population Health, and other stakeholders on channel management opportunities • 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, trend forecasting, pipeline evaluation, or cost-of-care management • Demonstrated experience identifying, evaluating, and developing strategies to address pharmacy trend drivers, including specialty drug spend, biosimilars, generic launches, pipeline therapies, and utilization management opportunities • Strong analytical skills with experience interpreting pharmacy utilization, trend, and financial data to identify actionable opportunities • Experience developing business cases, financial impact assessments, or pharmacoeconomic analyses used to support formulary, utilization management, biosimilar, or trend mitigation decisions • Knowledge of formulary management, utilization management strategies, pharmacoeconomics, and specialty pharmacy market dynamics • Strong quantitative and analytical skills, with proficiency presenting trend data to clients or executive audiences • Experience with PBM trend reporting tools and client-facing communication • Familiarity with net-cost formulary architecture and rebate-aware formulary strategy • Experience developing pharmacy trend forecasts, market impact models, or cost-of-care projections used to inform business or formulary strategy • Experience monitoring FDA pipeline developments and translating clinical, regulatory, and market events into formulary, utilization management, and operational readiness strategies

🏖️ 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 health, dental, vision and other benefits