Medical Director

• Design, structure, and develop long-term evolution of enterprise formulary and utilization management strategy.
• Accountable for the fiscal management of the department, including forecasting, budget development, ongoing variance monitoring, and trending.
• Serve as the authority on formulary strategy decisions, incorporating clinical evidence, market dynamics, and financial considerations.
• Provide clinical leadership in governance forums.
• Develop and lead clinical and formulary strategies aligned to organizational growth, client needs, and industry trends.
• Monitor emerging drug pipeline and therapeutic trends to proactively shape formulary positioning and strategy.
• Lead clinical strategy input for new business pursuits and client retention efforts.
• Foster cross-functional and inter-professional work teams to drive results in support of the strategic plan of the organization.
• Ensure formulary and clinical strategies align with regulatory requirements, accreditation standards, and internal policies.
• Design and oversee clinical criteria for prior authorizations, step therapy, and quantity limits to ensure appropriate medication use.
• Maintain accountability for clinical integrity and appropriateness of decision-making.
• Provide leadership, training, and supervision to team members.

Director, Clinical Strategy – RPh

• Oversee the performance and growth of Customer Service, Prescription Processing, Client-specific teams, managing both internal staff and external vendors
• Lead operational excellence across central fill pharmacy networks and courier delivery operations
• Lead your team with Key Performance Indicators (KPIs) to drive business success and increase efficiency while lowering the cost-to-fill on an annual basis
• Manage quality, turnaround time (TAT), and customer satisfaction metrics to ensure FuzeRx remains the preferred infrastructure partner for telehealth and pharma partners
• Establish requirements for capabilities and reporting, collaborating cross-functionally to deliver data-driven insights
• Analyze data to forecast staffing needs based on program performance, optimizing resource allocation across multiple roles
• Lead a large team of managers, supervisors and team members, establishing an environment of positive employee engagement and experience

Director, Rx Clinical Operations

• Work within the Medical Affairs organization to identify, establish, and manage collaborative professional relationships with community-based scientific leaders (SLs) and healthcare providers.
• Conduct peer-level scientific discussions and maintain a reliable presence to ensure SLs have a Medical Affairs contact within our company.
• Engage in proactive non-product discussions regarding scientific issues to understand real-world prevention gaps, persistent disparities, and barriers to uptake across various care settings.
• Facilitate appropriate scientific exchange of information with SLs, including integration of scientific knowledge with actionable insights to inform our Company's research, development and strategies.
• Communicate external stakeholder opinions, insights, and feedback on new data, clinical trends, and the evolving HIV treatment and prevention landscape to Medical Affairs HQ teams.
• Represent R&D at scientific meetings and congresses to understand the sentiment of the consumer and contribute to R&D debriefs, insight discussions, and post-congress reports.
• Develop and execute territory plans in alignment with global Virology strategy.
• Support data generation activities when requested by R&D leadership, including our company's Investigator Study Program (MISP).
• Identify potential investigators for participation in phase II-IV clinical development programs and provide scientific support for R&D sponsored trials as needed.
• Demonstrate and maintain in-depth knowledge of the assigned disease and therapeutic area(s) through educational efforts.
• Fully comply with all company policies and applicable laws, regulations, and ethical standards.

Virology Community MSL, Regional Medical Scientific Associate Director

• Leverage your background in Pain Medicine disciplines to deliver evidence-based medical reviews that support high-quality patient care.
• Collaborate with healthcare providers and stay current on healthcare regulations and industry developments as you review a wide range of cases.
• Start training remotely in a structured environment with support from trainers, mentors, and leadership to set you up for success.
• Complete time-sensitive, specialized evidence-based medical case reviews for medical necessity on EviCore’s case management software.
• Conduct physician consultation (peer-to-peer) calls with referring providers to discuss evidence–based medical necessity and appropriateness of the requested service or treatment.
• Leverage your clinical expertise to recommend alternative services or treatments as necessary.
• Work collaboratively with over 500 EviCore physician colleagues to help ensure patients receive proper care via evidence-based decision making.

Medical Director jobs in Hawaii

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Director, Clinical Strategy – RPh

Director, Rx Clinical Operations

Virology Community MSL, Regional Medical Scientific Associate Director

Medical Director – Pain Medicine