Director, Clinical Modeling

AffirmedRx is on a mission to improve health care outcomes by bringing clarity, integrity, and trust to pharmacy benefit management. We are committed to making pharmacy benefits easy to understand, straightforward to access and always in the best interest of employers and the lives they impact. We accomplish this by bringing total clarity to business practices, leading with clinical approaches, and utilizing state-of-the-art technology.

Join us in improving health care outcomes for all! We promise to do what’s right, always.

Position Summary:

The Director of Clinical Modeling leads the strategy and execution of health economics and outcomes research (HEOR) and population health initiatives to identify variation in clinical and economic outcomes and drive enterprise-wide, evidence-based improvements. This role leverages a strong understanding of pharmacy data, health economics, and financial analytics to design and apply real-world evidence and advanced modeling that supports quality improvement, cost management, and commercialization strategies. The Director partners cross-functionally with enterprise analytics, finance, and quality reporting teams to develop scalable dashboards, measure program impact, and inform decision-making across all business segments. They translate complex clinical, pharmacy, and financial data into actionable insights that strengthen RFP development, pricing strategies, and value-based care initiatives. Additionally, the Director provides strategic leadership and communicates integrated medical and economic insights to senior executives to enhance member outcomes and overall organizational performance.

What you will do:

HEOR Execution and Population Health Strategy:

• Lead population analytics to identify variation in clinical and economic outcomes
• Design and execute HEOR studies to demonstrate clinical and economic value
• Apply RWE and health economic modeling to prioritize population health initiatives
• Develop scalable, evidence-based interventions to improve outcomes

Quality Improvement and Enterprise Analytics:

• Analyze utilization, outcomes variation, and cost drivers across populations
• Translate insights into targeted quality improvement initiatives
• Support measurement of program impact and net cost performance
• Inform enterprise decision-making through data-driven analysis

Enterprise Quality Reporting and Collaboration:

• Partner with EQR to assess regional and business line variation in outcomes
• Support development of dashboards and reporting tools
• Assist with analytics for RFP development and performance reporting
• Ensure consistent quality, utilization, and cost measurement

Medical Insights and Executive Communication:

• Provide guidance on medical insight capture and interpretation
• Communicate clinical, quality, and economic insights to leadership
• Translate analytics into actionable recommendations
• Support value-based decision-making across the organization

What you need:

• PharmD and Master’s Degree required. PhD preferred
• 10+ years of experience in HEOR, clinical data analytics, or healthcare economic modeling
• Strong proficiency in programming languages such as R, Python, SQL, or similar tools
• Deep understanding of the U.S. healthcare system, including payer, provider, and value-based care environments
• Expert-level knowledge of HEOR methodologies, real-world evidence (RWE), and health economic modeling techniques
• Experience working with large healthcare datasets and translating complex data into actionable insights
• Strong analytical and problem-solving skills with the ability to interpret and communicate complex findings
• Proven ability to collaborate cross-functionally and present insights to senior leadership and non-technical stakeholders

What you get:

• To impact industry change in the pharmacy benefits management space, while delivering the highest quality patient outcomes
• To work in a culture where people thrive because when OUR team thrives, OUR business thrives
• Competitive compensation, including health, dental, vision and other benefits

Note:

AffirmedRx is committed to providing equal employment opportunities to all employees and applicants for employment. Remote employees are expected to maintain a professional work environment free of distractions to ensure optimal performance and collaboration.

Originally posted on Himalayas