Director, Pharmacy Trend and Pipeline Strategy

Accountabilities:

• • Own pharmacy trend forecasting and market surveillance, identifying emerging cost drivers, utilization patterns, and shifts that could materially affect pharmacy spend.
  • Monitor the drug development pipeline and evaluate new and emerging therapies across clinical, financial, operational, regulatory, and formulary dimensions.
  • Assess therapeutic category changes, market developments, access strategies, and industry trends to identify opportunities for proactive intervention.
  • Develop and maintain a multi-year pharmacy trend mitigation roadmap aligned with strategic and organizational priorities.
  • Recommend formulary, utilization management, biosimilar, generic, and channel management strategies designed to address emerging cost pressures.
  • Evaluate high-impact and new-to-market therapies before launch and translate clinical and market intelligence into actionable recommendations.
  • Lead the development of biosimilar strategies, including formulary positioning, utilization management, conversion approaches, adoption monitoring, and provider education.
  • Identify formulary and benefit design opportunities that balance clinical outcomes, affordability, and pharmacy spend.
  • Contribute to clinical intelligence governance by evaluating trend drivers and prioritizing intervention opportunities.
  • Partner with clinical modeling and financial stakeholders to develop financial impact assessments, pharmacoeconomic analyses, savings projections, and ROI estimates.
  • Quantify projected trend drivers, cost-of-care impacts, savings opportunities, and the expected value of proposed strategies.
  • Serve as the clinical lead for pipeline, trend, biosimilar, and pharmacoeconomic evaluations presented to Pharmacy & Therapeutics leadership.
  • Develop strategic recommendations and clinical content for enterprise and client-facing trend reports.
  • Collaborate with specialty, trade relations, population health, and other stakeholders to identify and implement channel management opportunities.
  • Communicate complex clinical, financial, and market insights clearly to executives, clients, and cross-functional business partners.
  • Monitor FDA pipeline developments and translate clinical, regulatory, and market events into formulary, utilization management, and operational readiness strategies.

  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, forecasting, pipeline evaluation, or cost-of-care management.
  • Demonstrated experience identifying pharmacy trend drivers and developing strategies addressing specialty drug spend, biosimilars, generic launches, pipeline therapies, and utilization management opportunities.
  • Strong quantitative and analytical capabilities, including the ability to interpret pharmacy utilization, trend, and financial data and turn findings into actionable strategies.
  • Experience developing business cases, financial impact assessments, pharmacoeconomic analyses, trend forecasts, market impact models, or cost-of-care projections.
  • Strong knowledge of formulary management, utilization management, pharmacoeconomics, specialty pharmacy, and broader pharmacy market dynamics.
  • Familiarity with net-cost formulary architecture and rebate-aware formulary strategy.
  • Experience using PBM trend reporting tools and presenting complex trend information to clients, executives, and other senior stakeholders.
  • Ability to evaluate clinical, regulatory, and market developments and translate them into practical commercial, clinical, and operational strategies.
  • Strong communication and presentation skills, with the ability to make complex clinical and financial concepts accessible to varied audiences.
  • Strategic mindset with strong judgment, analytical rigor, and the ability to identify emerging risks and opportunities before they materially affect outcomes.
  • Strong cross-functional collaboration skills and the ability to influence decisions across clinical, financial, commercial, and executive teams.
  • Comfortable working remotely while maintaining a professional, focused, and collaborative work environment.

  Benefits:

  • Opportunity to influence meaningful change in the pharmacy benefits management industry.
  • Ability to contribute to strategies focused on affordability, quality, and improved patient outcomes.
  • Competitive compensation package.
  • Health insurance benefits.
  • Dental insurance benefits.
  • Vision insurance benefits.
  • Additional employee benefits and programs.
  • Remote work environment with expectations for a professional, distraction-free workspace.
  • Collaborative culture focused on employee growth, team performance, and shared success.