Formulary & Clinical Insights Lead

Doctor of Pharmacy (PharmD) Degree from an accredited institution
Current, unrestricted registered pharmacist license(s)
Possess a strong knowledge of drug therapeutics, disease state management, and treatment guidelines as part of the development of a clinical strategy
Leverage a deep knowledge of highly managed specialty medications/strategies, formulary development and maintenance processes, utilization management, and product pipeline to develop a formulary strategy
Understanding of financial arrangements within the landscape between pharmaceutical companies, PBMs, clients, payers, GPOs, aggregators, and members
Possess strong understanding of language criteria to develop rebate, formulary, and utilization management strategies
Proficient in Microsoft office Suite with emphasis on Microsoft Excel and PowerPoint
Ability to balance multiple complex projects simultaneously
Exceptional written and verbal communication skills
Ability to speak clearly and concisely, conveying complex or technical information to various audience type
Extremely flexible, highly organized, self-starter, and able to shift priorities easily
Attention to detail and commitment to delivering high quality work product
Proven ability to work well and collaboratively cross functionally, with multiple teams or departments in a fast-paced environment
Ability to travel
Responsible for adherence to the Capital Rx Code of Conduct including reporting of noncompliance.

Utilize comprehensive understanding of clients’ formularies and rebates to develop and present strategies that that promote lowest net-cost options within specific therapeutic classes
Lead and develop financial modeling using client’s formulary and benefit structure to identify opportunities for formulary optimization that is based on various data sources, and utilization data
Develop repeatable methods to perform multiple analysis to compare and to evaluate the outcomes for each strategy
Create reporting standards to track financial performance of client adoption of strategies and summarize key metrics of progress
Leverage strong project management skills to manage multiple requests and have a sense for details that ensures accuracy of information
Align internal stakeholders on strategy and to present externally to clients
Stay up to date on the drug pipeline and its impact or forecasting potential impact on drug classes/rebates/utilization/modeling
Ensuring rebate compliance and clinical auditing of client custom formulary setup and UM criteria
Vendor relationship and management
Participate in quality performance initiatives
Responsible for adherence to the Capital Rx Code of Conduct, including reporting of noncompliance.