AffirmedRx is on a mission to improve healthcare outcomes by bringing integrity, clarity, and trust to pharmacy benefit management. We are committed to making pharmacy benefits easy to understand, straightforward to access and always in the best interest of employers and the lives they impact. We accomplish this by bringing total clarity to business practices, leading with clinical approaches, and utilizing state-of-the-art technology.
Join us in improving healthcare outcomes for all! We promise to do what’s right, always.
Position Summary:
As the Vice President, Pharmacy Clinical & Specialty Strategies, senior executive, you will be responsible for shaping and executing AffirmedRx’s pharmacy strategy, with a focus on the development and oversight of clinically sound, compliant, and impactful formulary management strategies, specialty drug programs, and clinical policy development. This leadership position is responsible for advancing our formulary strategies to bring clarity, integrity, and trust to our pharmacy benefit management services. With extensive expertise in Managed Care, Pharmacy Benefit Management (PBM), and Clinical Pharmacy, you will set and uphold clinical policies, lead cross-functional initiatives, and provide expert clinical recommendations across therapeutic areas. Additionally, you will chair our Pharmacy and Therapeutics Committee and guide a high-performing team of Analysts and Clinicians to deliver on the organization’s goals. This role drives innovation, ensures regulatory compliance, and aligns pharmacy operations with broader organizational goals.
What you will do:
Formulary Development and Maintenance:
- 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
Formulary & Policy Oversight:
- 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
Utilization Management Protocols:
- 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
Team Leadership and Development:
- 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
Business Growth & Innovation:
- 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
What you need:
- 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%)
What you get:
- 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
Note:
AffirmedRx is committed to providing equal employment opportunities to all employees and applicants for employment. Remote employees are expected to maintain a professional work environment free of distractions to ensure optimal performance and collaboration.
