Director of Pharmacy Analytics & PBM Strategy

smartlightanalytics; United States; Remote; USD 150,000 - 230,000; Full time

Job summary

SmartLight Analytics seeks a Director of Managed Care Pharmacy Analytics to lead clinical and analytical discussions with clients and PBMs. You will guide model development and payment integrity initiatives, ensuring clinically sound, contractually aligned outcomes.

Collaboration with data science, product, and operations is essential to shaping pharmacy strategy and delivering actionable insights. The role requires deep PBM expertise, strong communication skills, and the ability to translate

Qualifications

• PharmD, with a Managed Care Residency preferred
• Training in analytic methods and/or pharmacy data analysis recommended
• Minimum 6-8 years of experience in pharmacy benefit management, with meaningful client-facing or PBM-facing experience.
• Minimum of 3 years' experience in analyzing pharmacy claims data, especially payment integrity issues.
• Demonstrated understanding of how PBM operations work in practice, e.g., how claims adjudicate, how pricing/rebate terms are administered, and where contract terms and real-world operations diverge.
• Demonstrated ability to interpret PBM contract terms (pricing guarantees, rebate arrangements, definitions) and connect them to clinical and financial impact.
• Comfortable partnering closely with an analytics team and speaking independently to their findings, without personally performing every underlying analysis.

Responsibilities

• Serve as the primary pharmacy/clinical SME on client calls, translating analytics into clear, actionable stories for clients.
• Bring working knowledge of PBM operations, including claims adjudication and pricing/rebate terms in practice.
• Potentially act as clinical lead for PBM RFP evaluations and collaborate with analytics to ensure findings are clinically and contractually sound.
• Partner with the data science team to shape and validate the clinical logic behind pharmacy models and AI/algorithm development.
• Ensure analytic capabilities make clinical and operational sense before they enrich our products.
• Integrate payment integrity findings into the broader PBM strategy and client narrative.

Skills

Executive presence

PBM operations

Data storytelling

Client-facing

Cross-functional collaboration

Education

PharmD

Managed Care Residency

Analytics training

Tools

SAS

SQL

Excel

Job description

SmartLight Analytics seeks a Director of Managed Care Pharmacy Analytics to lead clinical and analytical discussions with clients and PBMs. You will guide model development and payment integrity initiatives, ensuring clinically sound, contractually aligned outcomes.

Collaboration with data science, product, and operations is essential to shaping pharmacy strategy and delivering actionable insights. The role requires deep PBM expertise, strong communication skills, and the ability to translate