Vice President, Trade Relations & Formulary Strategy

Trade Relations & Manufacturer Strategy

• Lead manufacturer negotiations for rebates, discounts, and value-based contracts aligned with financial objectives and client transparency.
• Oversee rebate GPO partnerships and administration for compliance, accuracy, and alignment with pass-through model.
• Monitor pharmaceutical market dynamics, generic pipelines, and biosimilar launches to position trade and contracting strategies proactively.
• Provide executive oversight for rebate financial modeling, market assessments, and guarantee development with Pricing and Underwriting teams.

Formulary Strategy & Management

• Own formulary strategy grounded in clinical evidence, market intelligence, and lowest-net-cost modeling.
• Lead and oversee P&T/Formulary Advisory Committee, setting governance, documentation, and objective decision-making standards.
• Partner with Sales and Customer Success to articulate clinical and financial value of formulary strategies to clients and consultants.
• Experience with formulary and utilization management across government programs (Medicare and Medicaid).

Clinical Criteria Strategy & Management

• Direct development and deployment of clinical criteria for Prior Authorizations (PA), Step Therapy (ST), and Quantity Limits (QL) to ensure appropriate utilization and optimize outcomes.
• Ensure clinical criteria and UM programs maintain independence from manufacturer influence, prioritizing patient health and employer savings.
• Collaborate on innovative management strategies for high-cost specialty drugs, gene therapies, and orphan drugs.

Cross-Functional Leadership

• Partner with executive peers across Pharmacy Networks, Clinical Operations, Sales, Finance, and Analytics for integrated supply chain execution.
• Build, mentor, and scale a team of trade relations directors, clinical pharmacists, and data analysts.

Requirements

• 12+ years of progressive leadership experience in PBM trade relations, pharmaceutical market access, formulary management, or related clinical strategy roles.
• Experience across Commercial, Medicare, Medicaid, Exchange lines of business.
• Deep understanding of PBM ecosystem, drug manufacturer contracting, GPO structures, and differences between traditional rebate aggregators and 100% pass-through PBMs.
• Proven track record negotiating complex rebate and value-based contracts with major pharmaceutical manufacturers.
• Strong grasp of clinical pharmacology, drug pipelines, and evidence-based medicine to guide P&T committees and clinical criteria.
• Strong financial modeling skills to translate rebate structures into lowest-net-cost strategies.
• PharmD highly preferred; Bachelor’s in Business, Finance, or Healthcare Administration with extensive experience considered. Active pharmacist license a plus.