Managed Care Pharmacy Analytics

Location: Remote

Company

hirify.global helps self-funded employers reduce wasteful healthcare spending through proprietary data analysis without disrupting employee benefits.

What you will do

• Serve as the primary pharmacy and clinical subject-matter expert on client and PBM calls.
• Translate payment integrity findings and pharmacy analytics into clear, actionable client narratives.
• Guide PBM RFP evaluations and assess pricing guarantees, rebate arrangements, and contract findings.
• Partner with data science teams to shape and validate clinical logic for pharmacy models and AI-driven analytics.
• Support formulary and utilization management rules, drug classification, specialty and limited-distribution drug designations, and anomaly detection.
• Collaborate with product, account management, legal, operations, and technology teams on pharmacy strategy and implementation.

Requirements

• PharmD; managed care residency is preferred.
• 6–8 years of experience in pharmacy benefit management, including meaningful client-facing or PBM-facing work.
• At least 3 years of experience analyzing pharmacy claims data, particularly payment integrity issues.
• Advanced knowledge of pharmacy benefits, PBM contracting and operations, claims adjudication, formulary management, and utilization management.
• Ability to interpret PBM contract terms and connect them to clinical and financial impact.
• Strong executive presence, analytical judgment, communication, collaboration, and compliance focus.

Nice to have

• Managed Care Residency.
• Training in analytic methods or pharmacy data analysis.

Culture & Benefits

• Remote work environment.
• Cross-functional collaboration across clinical, analytics, product, legal, operations, and technology teams.
• Work focused on reducing wasteful healthcare spending while preserving employee benefits.