Director, Drug Intelligence & Formulary Strategy

Job Title: Director, Drug Intelligence & Formulary Strategy Location: Remote – Work-from-Home Reports To: Head of Clinical & Analytic Strategy Join us in powering the future of healthcare cost containment! Expion Health is seeking a Director of Drug Intelligence & Formulary Strategy to lead our clinical and formulary operations. This strategic role will drive innovation at the intersection of data, clinical expertise, and technology, ensuring our clients and partners benefit from best-in-class formulary management and drug intelligence solutions. Are you up for the challenge? You'll collaborate with Clinical, Analytics, Sales, Marketing and leadership to shape and execute formulary strategy, synthesize clinical and financial data, and deliver exceptional value to our clients. We are looking for a clinical leader with deep expertise in formulary management, drug intelligence, and regulatory compliance. Essential Functions • P&T Committee Leadership • Lead and manage the Pharmacy & Therapeutics (P&T) Committee, setting agendas, managing logistics, preparing pre-read materials, and documenting post-meeting actions. • Ensure impartial clinical oversight by engaging clinicians without conflicts of interest in designing and approving clinical requirements and guidelines. • Track committee recommendations and maintain comprehensive records supporting each decision for regulatory review (Medicare, Medicaid, ACA, HIX). • Oversee the documentation of medical evidence supporting formulary decisions and utilization management policies. • Maintain compliance with all relevant regulatory requirements. • Formulary Strategy & Drug Intelligence • Formulate and maintain Expion's formulary strategy, synthesizing vendor partner data into actionable insights. • Serve as clinical liaison between Expion and external partners to evaluate and execute formulary strategies that optimize clinical and financial outcomes. • Lead clinical innovation initiatives, including emerging markets (e.g., rare disease, biosimilars, obesity treatments, health equity). • Clinical Content & Policy Development • Develop and maintain clinical content, including therapeutic class reviews, drug monographs, and custom utilization management criteria. • Oversee formulary coverage policies and rules, analyzing differences between various formularies. • Document medical evidence supporting utilization management processes and ensure regulatory compliance. • Client-Facing Leadership & Support • Respond to clinical inquiries and provide rationale for formulary decisions. • Ensure alignment between clinical strategy and client expectations. • Partner with marketing to create client-facing materials demonstrating clinical rigor. • Provide clinical expertise and guidance to clients and internal teams on drug lists, drug therapy, and treatment protocols. • Stay current on emerging trends, advancements, drugs, and drug manufacturer changes. • Perform other duties as assigned to support departmental and organizational goals. Required Expertise • Doctor of Pharmacy (Pharm.D.) or equivalent; Board Certification preferred • Active pharmacist license in good standing, in at least one state • 5+ years' experience in clinical formulary strategy, drug intelligence, or managed care pharmacy • Demonstrated expertise in engaging with P&T Committees and maintaining regulatory documentation • Strong knowledge of regulatory requirements (Medicare, Medicaid, ACA, HIX) • Proven ability to synthesize clinical and financial data into actionable strategies • Ability to create and deliver client-facing materials that demonstrate clinical rigor and strategic value • Excellent communication, presentation, and stakeholder management skills • Ability to work independently and collaboratively in a fast-paced, distributed environment • Strong problem-solving, critical thinking, and organizational skills • Demonstrated ability to think/act strategically • As conditions allow, ability to travel for relevant business needs Preferred Skills • Experience in client-facing roles, including responding to clinical inquiries and supporting formulary implementations • Familiarity with trend management strategies and clinical innovation initiatives • Experience mentoring and training pharmacists, residents, or students • Strong writing and copy-editing abilities What It's Like to Work with Us Expion Health has been challenging the industry status quo for over 30 years, leading with ground-breaking innovation in a wide variety of healthcare cost-management solutions. Embracing the latest opportunities that technology can offer within a rapidly evolving industry, we provide exceptional service, technology, and product innovation to meet greater challenges in healthcare cost management. We have a distributed workforce so you can work from anywhere in the continental United States. Because of our distributed nature we have cultivated a connected culture that includes town halls, one-on-ones with executive leadership, educational forums, and even social clubs We offer comprehensive benefits package which includes the following: • Medical, dental, and vision insurance • Short- and long-term disability • Life insurance and AD&D • Supplemental life insurance (Employee/Spouse/Child) • Voluntary Accident, Critical Illness and Hospital Indemnity Insurance • Healthcare and dependent care Flexible Spending Accounts • Healthcare Savings Account • 401(k) Savings and Investment Plan with company match • Paid time off • Phone and Internet allowance Expion Health is an equal opportunity employer, and all qualified applicants will receive consideration for employment without regard to race, color, religion, age, sex, national origin, disability status, genetics, protected veteran status, sexual orientation, gender identity or expression, or any other characteristic protected by federal, state or local laws. 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