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

• Provides medical oversight of assigned clinical studies in the duty as a medical monitor
• Often serves as primary medical contact for customers for assigned clinical studies
• Provides medical input and oversight in support of the Drug Safety and Pharmacovigilance department
• Responsible for protocol design and development, upon request
• Provides input into protocol amendments
• Develops and delivers project-specific and therapeutic training to project team members and clinical site staff; provides training to customer staff as needed
• Provides medical and therapeutic input to Study Start Up, Feasibility, and Subject Identification efforts
• Provides medical input into data collection tools, monitoring plans, and review and analysis plans
• Provides oversight to assigned Medical Scientist staff and Medical Director colleagues to review clinical data
• Presents identified trends and issues, and mitigation strategies, to customers and project team members to minimize risks to subject safety or integrity of study data
• Provides after-hours medical coverage for clinical studies
• Adheres to all enterprise policies, work instructions, standard operating procedures, and project plans
• Adheres to customer policies and standard operating procedures, as required in project plans
• Maintains in-depth knowledge of FDA and worldwide drug development regulations and national and ICH Good Clinical Practice (GCP) guidelines
• May support responses to Requests for Proposals (RFPs) or Bid Defense Meetings (BDMs), upon request
• May provide input to clinical development or regulatory teams within the Company, upon request
• May represent the Company at scientific meetings, upon request

Medical Director – HIV Research, Clinical/Observational Research

• Provide strategic leadership and clinical oversight for DSNP/FIDE complex populations.
• Lead a team of Senior Medical Directors/Medical Directors within the Center of Excellence (COE) Duals.
• Drive medical management programs and policies that improve quality, cost, and outcomes across the continuum of care.
• Ensure compliance, operational excellence, and superior member experience.
• Actively participate in scheduled team and leadership meetings supporting the EMD.

Medical Director jobs in Rhode Island

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Director, Clinical Strategy – RPh

Director, Rx Clinical Operations

Medical Director – HIV Research, Clinical/Observational Research

Lead Senior Medical Director, DSNP