Leads pharmacy trend forecasting, pipeline surveillance, biosimilar and formulary strategy, utilization management, and cost-of-care optimization. Evaluates emerging therapies, specialty drug trends, and market developments; develops mitigation roadmaps, financial impact assessments, and pharmacoeconomic analyses. Partners with clinical, financial, specialty, and trade stakeholders to support formulary decisions, Pharmacy and Therapeutics Committee recommendations, client reporting, and executive decision-making.
AffirmedRx is on a mission to improve health care outcomes by bringing clarity, integrity, 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 health care outcomes for all! We promise to do what’s right, always.
Position Summary:
The Director, Pharmacy Trend & Pipeline Strategy serves as AffirmedRx's lead strategist for emerging pharmacy trends, pipeline intelligence, and cost-of-care optimization. The role proactively identifies, evaluates, and recommends strategies related to evolving market dynamics, specialty drug trends, biosimilars, generic launches, utilization patterns, and other emerging cost drivers. Through cross-functional collaboration, this position drives strategic interventions that improve affordability, support formulary and clinical decision-making, and position AffirmedRx and its clients ahead of market change.
What you will do:
Pharmacy Trend and Pipeline Strategy:
- 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
Trend Mitigation and Clinical Strategy Development:
- 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
Biosimilar and Formulary Optimization:
- 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
Clinical Intelligence and Financial Analysis:
- 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
Clinical Leadership and Stakeholder Communication:
- 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
What you need:
- 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
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 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.
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