Senior Director, Transformation Data Analytics

Posted Yesterday
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Hiring Remotely in United States
Remote
Senior level
Artificial Intelligence • Healthtech
The Role
Leads a two-year transformation migrating 1,000+ customers to a new PBM operating and pricing model. Oversees FMV pricing governance, contract redesign, network reimbursement, retail and specialty strategy, operational readiness, compliance, financial modeling, and margin optimization. Partners with Sales, Account Management, Legal, network teams, and executives to manage change, integrate Care Guides, ensure data integrity, and report progress and financial impacts to senior leadership and the Board.
Summary Generated by Built In

It's fun to work in a company where people truly BELIEVE in what they're doing!

We're committed to bringing passion and customer focus to the business.

                                                                                                                                                                                                                                                                   

The Senior Director, Transformation Data Analytics Modernization will be accountable for designing and executing the two-year transition of 1,000+ customers to the new operating model as well as finding value within the existing pricing framework. This role combines strategic leadership with hands-on execution across pricing architecture, network strategy, contracting, and operational delivery. Responsible for driving cross-functional alignment, managing change at scale, and ensuring a disciplined, governed transition.

                                                                                                                                                                                                                                                                   

Role and Responsibilities

1. Enterprise Pricing & Model Governance

  • Build out the design, refinement, and governance of the multi‑category FMV pricing model.

  • Ensure all pricing aligns with SB‑41, H.R. 7148, FTC/Cigna requirements, internal FMV standards, and all developing requirements.

  • Analyze the integration of Care Guides into the pricing architecture, including standalone and bundled pricing logic.

  • Drive pricing analytics, modeling, and financial impact forecasting of this project/migration.

2. Customer Migration & Contract Rationalization

  • Support the two‑year migration of 1,000+ customers to the new pricing model, supporting AM and Sales Functions.

  • Analyze details of contract redesign, negotiation strategy, and execution.

  • Partner with Sales, Account Management, and Legal to ensure seamless customer transitions.

3. Network, Retail, And Specialty Strategy Alignment

  • Monitor network reimbursement, U&C methodologies, and specialty channel strategies to ensure alignment with the new model and maximize opportunity.

  • Collaborate with network leadership to maintain competitiveness and margin integrity.

  • Support pharmacy contracting modernization and compliance.

4. Operational Readiness & Reporting Infrastructure

  • Assist in cross‑functional readiness across billing, claims, reporting, analytics, and compliance.

  • Ensure data integrity, auditability, and system alignment with the new pricing model.

5. Care Guides Integration & Service Model Transformation

  • Define how Care Guides consolidates and delivers highlighted key service categories.

  • Build operational workflows and performance metrics for Care Guides.

  • Ensure seamless customer and member experience during and after migration.

6. Executive Leadership & Change Management

  • Serve as a sponsor for the transformation program.

  • Assist internal education, training, and communication across LucyRx.

  • Develop reporting to track progress, risks, and financial impacts to be presented to the CFO, CEO, and Board.

                                                                                                                                                                                                                                                                   

Qualifications and Education Requirements

Required

  • 9+ years of PBM, health plan, or healthcare strategy leadership.

  • Deep expertise in network management, pricing, contracting, and reimbursement strategy.

  • Proven ability to implement large‑scale transformation and efficiency programs.

  • Strong understanding of MAC management, U&C methodologies, retail contracting, and specialty strategy.

  • Demonstrated success in margin optimization, financial modeling, and guarantee oversight.

Preferences

  • Experience leading pricing modernization or FMV‑based pricing transitions.

  • Background in PBM retail network strategy across major chains.

  • Familiarity with URAC accreditation, compliance frameworks, and regulatory reporting.

  • Bachelor’s or equivalent degree.

Leadership Attributes

LucyRx is seeking a leader who is:

  • Strategic and operational — able to design the model and execute it.

  • Analytically rigorous — comfortable with pricing, modeling, and financial forecasting.

  • Relationship‑driven — able to integrate quickly into the LucyRx culture and leverage internal and external relationships to negotiate with pharmacies, customers, and internal teams.

  • Change‑oriented — thrives in transformation environments.

  • Compliance‑minded — understands regulatory expectations and audit readiness.

  • Member‑centric — committed to elevating the Care Guides experience.

Physical Requirements

The physical demands described here are representative of those that must be met by an employee to successfully perform the essential functions of this job.

This is a largely sedentary role; however, some standing, walking, bending, and reaching may be required.  Regularly operates in an office or home office setting which involves utilizing a computer, mouse, keyboard, and occasionally operates other standard office equipment, such as printer, copier, phone.  Travel may be required by either car or airplane, or a combination of multiple modes of transportation.

Skills Required

  • 9+ years of PBM, health plan, or healthcare strategy leadership
  • Deep expertise in network management, pricing, contracting, and reimbursement strategy
  • Experience implementing large-scale transformation and efficiency programs
  • Strong understanding of MAC management, U&C methodologies, retail contracting, and specialty strategy
  • Demonstrated success in margin optimization, financial modeling, and guarantee oversight
  • Experience leading pricing modernization or FMV-based pricing transitions
  • Background in PBM retail network strategy across major chains
  • Familiarity with URAC accreditation, compliance frameworks, and regulatory reporting
  • Bachelor's degree or equivalent
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The Company
HQ: Bethesda, MD
300 Employees
Year Founded: 2023

What We Do

LucyRx is an independent, next-generation pharmacy benefit manager (PBM) serving health plan sponsors and members nationwide. It seeks to simplify prescription care and improve access through an integrated specialty pharmacy network, formulary marketplace, and next-day home delivery. Its proprietary LucyIQ™ artificial-intelligence platform provides real-time insights for evidence-based clinical decisions, clear pricing, and exceptional service from U.S.-based pharmacy technicians for complex medication needs.

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