Director, Finance and Business Intelligence

Position Summary

The Director, Finance and Business Intelligence leads financial and analytical oversight of pharmacy benefit performance, with a focus on managing Net PMPM cost, rebate processes, and overall operational effectiveness. This role is responsible for monitoring network pricing, pharmacy claims trends, and customer-level performance to drive data-informed decision-making. The Director designs and maintains robust analytics and controls to ensure accurate rebate forecasting, reporting, and reconciliation, while supporting pricing and underwriting with real-time insights on cost drivers and unit economics. Partnering cross-functionally with operations, IT, and clinical teams, this leader identifies cost trends, improves resource allocation, and advances strategic initiatives that enhance value creation. Through a combination of financial expertise and advanced analytics, the Director drives efficiency, cost savings, and continuous performance improvement across the PBM organization.

What you will do

• Financial Performance and Cost Management:

  • Track, manage, and report on performance and cost guarantees, with a focus on Net PMPM and operational performance
  • Monitor pharmacy cost drivers and identify trends impacting overall spend and margin
  • Partner with stakeholders to implement cost containment and performance improvement strategies
  • Ensure alignment of financial outcomes with organizational goals and contractual commitments

• Network and Claims Analytics:

  • Analyze network pricing, pharmacy claims data, and customer-level performance trends
  • Provide actionable insights to support data-driven decision-making across the organization
  • Evaluate unit economics, formulary impacts, and reimbursement structures
  • Identify opportunities to optimize network performance and reduce cost variability

• Rebate Management and Financial Controls:

  • Establish and oversee end-to-end rebate processes, including forecasting, tracking, and reporting
  • Ensure accurate reconciliation of rebate accruals with pharmacy claims data
  • Manage customer payments and maintain strong internal controls to ensure compliance and accuracy
  • Continuously improve processes to enhance transparency, efficiency, and audit readiness

• Strategic Insights and Cross-Functional Partnership:

  • Support pricing and underwriting teams with real-time financial and operational insights
  • Develop and maintain advanced analytics to drive efficiency and value creation initiatives
  • Collaborate with operations, IT, and clinical teams to optimize resource allocation
  • Provide strategic financial guidance to enhance PBM performance and support long-term growth initiatives

What you need

• Bachelor’s Degree in Finance, Accounting, Business Administration or related field

• 10+ years of experience in finance, analytics, or pricing/underwriting roles within Pharmacy Benefit Management or related industry

• Expertise in claims analytics, rebate modeling, and formulary management

• Strong understanding of pharmacy network economics, PBM contracting, and regulatory compliance

• Advanced proficiency with analytical tools and platforms (e.g., SQL, SAS, Tableau) for claims and rebate data analysis

• Proven track record of delivering actionable insights and supporting high-impact initiatives in PBM environments

• Comfortable operating in a fast-paced, growth environment without defined processes

• Proven ability to translate complex data into clear business recommendations and executive-level communications

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