Director, PBM Specialty Strategy

ABOUT THE ROLE

Our PBM goal is to help clients better manage pharmacy spend to make drugs more affordable for their employees and dependents. Rightway is responsible for designing, building, and operating a new-to-the-world PBM model based on our core tenets: fairness & transparency, unlocking the supply chain, supporting the physician-patient relationship, and utilizing navigation to empower consumers.

The exponential growth of specialty drug spend has made the successful management of specialty drug products absolutely critical for Rightway, our plan sponsors, and ultimately the members utilizing these drugs. Rightway strives for a holistic and member centric approach to specialty pharmacy management.

The role requires equal parts strategy and execution. The ideal candidate has a sense of urgency to build and grow and is also able to step back and assess priorities, goals, and KPIs.

WHAT YOU'LL DO

• Continue to build and iterate on the Rightway specialty pharmacy strategy
• Lead a hybrid team of virtual and in office employees, including two specialty Sr. Managers, specialty clinical pharmacists, and certified pharmacy technicians
• Manage Rightway’s current specialty programs: direct clinical management of specialty members, optimize our specialty supply chain network, copay maximization, patient assistance, and supporting all PBM aspects of specialty drugs (formulary, clinical pathways, etc.)
• Develop and implement future strategic specialty programs such as such as international sourcing, 340b, medical management, and assess trends to identify additional opportunities
• Develop and maintain SOP’s for all specialty programs offered by Rightway
• Identify and implement methods to leverage technology to enhance member experience and internal operations
• Build relationships with key external stakeholders
• Refine and oversee a set of KPIs to track success of specialty programs
• Develop and mentor team members on their career goals
• Identify and surface patterns to senior leadership with regards to root cause analysis
• Use experience, knowledge, and data to anticipate future opportunities and own solution development
• Scale operations to support rapid growth and develop strategies to support peak or high-volume time periods
• Foster a culture of empathy and respect in all interactions with customers and co-workers
• Create an internal work environment that prioritizes continuous improvement, innovation, and employee engagement

WHO YOU ARE

• PharmD degree
• 5-10 years experience in specialty pharmacy benefit management with a Health plan or PBM
• At least 5 years of leadership experience with at least 3 years as Director or above
• Strong financial and analytical skills
• Relentlessly focused on member experience in aspects of specialty pharmacy
• Proven success leading multiple large, high priority, cross functional clinical and operational strategic programs
• A strong track record of driving results and meeting financial targets that achieve the goals of the PBM/Health Plan, plan sponsor, and member.
• Demonstrated ability to create an inclusive environment that's welcoming to all
• Outstanding interpersonal skills and ability to communicate clearly and effectively
• Highly collaborative with cross-functional stakeholders and able to influence decisions
• Analytically minded, with an ability to leverage data to drive strategy and prioritization
• Comfortable with ambiguity and motivated by a dynamic environment
• Ownership mentality
• Strong PowerPoint and Excel skills, with a knack for storytelling