Senior Pharmacy Benefits Lead — PBM Strategy & Savings

Devoted Medical Services; Waltham (MA); Sur place; USD 111 000 - 173 000; Plein temps

Avantages offerts par ce poste

Employer sponsored health, dental and视

Generous paid time off

Stock options for all employees

Bonus eligibility for all roles

401K program

Parental leave program

And more....

Résumé du poste

Devoted Health in the United States is seeking a Pharmacy Benefits Senior Manager to own pharmacy trend for our commercial book and be the trusted voice on how PBM dollars land.

You will own the PBM relationship, decompose trend into cost and utilization, develop a savings pipeline, and lead implementations (formulary changes, plan-design rollouts). Coordinate with Finance, Legal, Clinical, Data, and HR/Total Rewards to keep programs on track and transparent.

Qualifications

• 5-8+ years in pharmacy benefits, PBM operations/account management, payer/managed care pharmacy, or benefits consulting with demonstrable ownership of PBM contracting and drug-trend outcomes.
• Deep, current command of PBM economics: pricing/discount guarantees, rebates, spread, formulary and UM levers, and specialty drug management.
• Proven trend management track record
• Strong analytics foundation: fluent with claims data, financial modeling, and BI tools; able to interrogate the math behind a PBM's reporting
• Rigorous project/program management of complex, multi-stakeholder initiatives.
• Working knowledge of ERISA fiduciary obligations and CAA/RxDC transparency requirements

Responsabilités

• Lead PBM procurement and RFPs
• Negotiate and re-negotiate contract terms (pricing/discount guarantees, dispensing fees, rebate guarantees, admin fees, definitions, audit and market-check rights)
• Track every performance and financial guarantee
• Commission and manage independent claims audits, rebate/pass-through audits, and mid-contract market checks
• Pursue and recover variances
• Evaluate emerging PBM and contracting models and drive build-vs-switch analyses

Connaissances

PBM contracting

Pharmacy benefits

Data analytics

Project management

ERISA fiduciary

Trend management

Formation

PharmD or RPh

Master's degree

Outils

BI tools

Claims data warehouses

Description du poste

Devoted Health in the United States is seeking a Pharmacy Benefits Senior Manager to own pharmacy trend for our commercial book and be the trusted voice on how PBM dollars land.

You will own the PBM relationship, decompose trend into cost and utilization, develop a savings pipeline, and lead implementations (formulary changes, plan-design rollouts). Coordinate with Finance, Legal, Clinical, Data, and HR/Total Rewards to keep programs on track and transparent.