Job Description

Job Description

Client Summary:

• Leading Independent Health Solutions & Pharmacy Benefit Provider
• Serves commercial health plans, government programs, employer groups, and millions of consumers.
• Continuously invests, innovates, and partners to enhance healthcare and pharmacy benefits.
• Key Benefits for Clients:
  • Improved clarity in healthcare and benefits
  • More coordinated and effective care solutions
  • Greater transparency and clinical oversight to manage costs
  • Increased flexibility, freedom, and choices
  • More engaged and empowered members

Position Responsibilities:

• Lead and manage the clinical team, driving strategy and continuous improvement.
• Develop and implement policies to enhance care, safety, and regulatory compliance.
• Align clinical initiatives with business strategy, P&T guidelines, and market messaging.
• Support sales, marketing, and product development with clinical expertise.
• Build key industry relationships and represent the company at events (6-8 days/month).
• Ensure seamless integration of clinical services across departments.
• Drive performance, growth, and financial milestones.

Experience & Skills:
Required Experience and Qualifications:

• MD or DO with Board Certification required
• 15+ years in PBM, health plan, or related industry, with 15 years in leadership
• Expertise in clinical efficacy, adverse event data, and study design analysis
• Proven medical educator skilled in peer-to-peer engagement and thought leadership
• Ability to articulate clinical, regulatory, and scientific strategies to executives, board members, clients, and staff
• Exceptional executive presence, presentation, and communication skills
• Deep knowledge of healthcare regulations, clinical guidelines, and pharmaceutical benefits management

Compensation $450k-$475k, ESOP or stock options Direct Recruiters Inc.

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