Senior Director

Summary

Join Rightway as a Senior Director, PBM Clinical Operations and lead the strategy, execution, and improvement of core PBM clinical services, including formulary operations, utilization management, and strategic rebate programming. Oversee operational and clinical performance, drive innovation, and ensure clinical operations contribute to Rightway’s growth and client outcomes. Lead a multidisciplinary team and collaborate with Product, Data & Insights, and Commercial teams to launch and refine clinical offerings. Serve as a primary clinical voice for external partners and clients, positioning Rightway as a high-value PBM partner focused on the Triple Aim. This role provides executive oversight of the Utilization Management program and formulary strategy, ensuring operational excellence, regulatory compliance, and alignment with financial and clinical goals. You will mentor and develop high-performing clinical and operational leaders.

Requirements

• PharmD required; MBA or related business training preferred
• 10+ years of progressive experience in pharmacy benefit management or managed care clinical operations
• Minimum 5 years of executive or senior leadership experience across formulary and UM domains
• Deep knowledge of formulary development, prior authorization policy, rebate strategy, and clinical program design
• Exceptional analytical and financial acumen; experience managing toward gross margin targets and operational KPIs
• Proven ability to scale clinical operations, lead change, and improve outcomes in fast-paced, high-growth environments
• Executive presence and excellent communication skills; comfortable interfacing with clients and internal leadership
• Highly collaborative, inclusive leader with a passion for building and empowering teams
• Strong ownership mindset; thrives in ambiguous, high-accountability settings

Responsibilities

• Lead PBM Clinical Operations across formulary management, utilization management, and rebate program execution
• Define and execute a long-term clinical operations roadmap that improves efficiency, enhances member experience, and supports business objectives
• Provide executive leadership of the Utilization Management program—including policy development, automation strategy, regulatory readiness, and client alignment
• Oversee formulary strategy and operations, including design, implementation, and maintenance of core and custom formularies; explore and implement alternative tiering models
• Serve as clinical lead for rebate strategy and execution; collaborate with manufacturers, rebate aggregators, and clients to optimize financial outcomes
• Establish operational models that align clinical performance with quality, compliance, and financial goals—including gross margin and client guarantees
• Collaborate with internal stakeholders in Product, D&I, and Marketing to design and commercialize clinical offerings that meet client and member needs
• Provide strategic guidance to the P&T Committee, including pipeline insights, formulary recommendations, and clinical impact assessments
• Drive continuous improvement across clinical workflows to ensure high service levels and enable pharmacists and clinicians to operate at the top of their license
• Represent Rightway in client-facing engagements, including strategic business reviews, clinical program reporting, and sales support
• Mentor and develop high-performing clinical and operational leaders

Preferred Qualifications

Strong background in Medicare and/or Medicaid program requirements a plus

Benefits

BASE SALARY: $180,000-120,000