AffirmedRx is on a mission to improve health care outcomes by bringing clarity, integrity, and trust to pharmacy benefit management. We are committed to making pharmacy benefits easy to understand, straightforward to access and always in the best interest of employers and the lives they impact. We accomplish this by bringing total clarity to business practices, leading with clinical approaches, and utilizing state-of-the-art technology.

Join us in improving health care outcomes for all! We promise to do what’s right, always.

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 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 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 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

Note:

AffirmedRx is committed to providing equal employment opportunities to all employees and applicants for employment. Remote employees are expected to maintain a professional work environment free of distractions to ensure optimal performance and collaboration.