Devoted Health
Drug Trend Management Pipeline Development Senior Manager
$110K–$172K
Remote USA · Manager · Full-time · Posted Aug 31, 2026
- Experience
- At least 5-8 years in managed care pharmacy, utilization management, drug trend, or program integrity, with meaningful Part B and Part D exposure.
About the job
Evaluates drug cost, safety, and integrity patterns across Medicare Part B and Part D, builds clinical and financial cases, and works with internal teams to turn validated opportunities into action.
What you'll do
- Assess surfaced opportunities for data validity, population definition, net spend, and existing interventions; document why opportunities are pursued or closed.
- Develop clinical and financial cases and recommend an appropriate response, such as a utilization management change, policy update, claim edit, partner coordination, or investigation referral.
- Feed findings and false positives into detection processes to improve future opportunity identification and prioritization.
What they ask for
- Deep pharmacy-domain expertise and ability to apply it to drug cost, safety, and integrity opportunities.
- At least 5-8 years of experience in managed care pharmacy, utilization management, drug trend, or program integrity, with meaningful Part B and Part D exposure.
- Medicare regulatory fluency and hands-on experience with standard pharmacy and medical claims data.
- Population-level analytical skills and strong written and verbal communication.
Nice to have
- Experience with detection, suspecting, or FWA models; pragmatic familiarity with agentic or LLM-assisted tooling.
- Familiarity with payment integrity, SIU, or actuarial workflows, and health plan, MA-PD, or PBM organizational settings.
Pay
$110,000 - $172,000 annually (base salary)
Tools
NCPDP, GPI, DAW, NDC, HCPCS
AI focus
Preferred familiarity with agentic or LLM-assisted tooling; the role may grow to shape how opportunities are produced and prioritized.
Model-written summary · the original posting is authoritative