Senior Pharmacy Specialist

About the role

Lead pharmacy program initiatives and implementation efforts, helping clients execute complex operational and strategic projects. Work with PBM migrations, system implementations, or large-scale pharmacy transformation initiatives.

Responsibilities

• Lead the development, identification and root cause of pharmacy opportunities through remediation with client counterparts
• Stay up to date on current events, changes in regulatory requirements and market trends impacting health plan reimbursement
• Exercise excellent judgement and clear and direct communication in all aspects of your work
• Work in a matrix management environment as a member of the pharmacy team, supporting multiple projects and actively participating in client-facing meetings
• Drive the design and delivery of opportunities to reduce payer drug costs, partnering closely with internal teams to implement recommendations
• Utilize analytics to uncover trends across pharmacy and medical drug spend, applying your knowledge of drug pricing and reimbursement methodologies (AWP, WAC, NADAC, MAC, CMS ASP), formulary strategy, and utilization management programs
• Maintain knowledge on regulatory changes, drug pricing updates, compendia changes, and market trends that impact pharmacy benefit strategy and clinical programs
• Prepare client-ready deliverables
• Apply strong critical thinking and analytics skills to identify patterns, inconsistencies, and opportunities within pharmacy and medical claims and develop practical recommendations and strategies for clients
• Other duties as assigned

Requirements

• 4+ years of experience in a role within pharmacy, PBM, pharmacy consulting or managed care organization
• Strong professional communication skills, including written, verbal, interpersonal, and in-person presentation expertise
• Experience coaching and mentoring team members
• Advanced proficiency in Microsoft Excel for data analysis and insights development
• Strong analytical, data interpretation, and problem-solving skills
• Able to identify client savings opportunities and develop actionable insights or business cases
• Bachelor’s degree or equivalent
• Must be legally authorized to work in the United States without the need for employer sponsorship

Preferred Requirements

• Experience in healthcare systems and digital platforms, Claims Adjudication and related tools, with the ability to leverage these systems to improve data quality, operational efficiency, and end-to-end healthcare processes
• Doctor of Pharmacy (PharmD)
• Expertise in pharmacy operations
• Basic/intermediate SQL for data analysis
• Demonstrated experience in pharmacy benefit management inclusive of benefit design, formulary strategy, utilization management programs, clinical programs PBM contracting, and analytics and reporting
• Track record in pharmacy and medical drug utilization analysis, cost containment, or value-based pharmacy strategy

Benefits

Flexible PTO, monthly half-day refuels, volunteer time off, 10 paid holidays
Own Your Day flexible work policy
Competitive majority employer-paid benefits: Medical, Dental, Vision, 401K Match
Generous paid parental leave options
Employer-paid Life Insurance, Short Term Disability, Long Term Disability
Charitable contribution matching program
New client commission opportunities and referral bonus program
Bike share discount program

Pay

The estimated base salary range for this position is $105,000 - $125,000. In addition to this base salary, individuals may be eligible for an annual discretionary bonus. This range is a part of a competitive, total compensation package together with our majority employer-paid benefits and incentive pay for eligible roles.