Shaw Industries · 4 weeks ago
Director of Clinical & Pharmacy Strategy
Shaw Plant 72, 900 VD Parrot Parkway, Dalton, GA 30721 USA
Full-time
Hybrid
Director/Executive
15+ years expShaw Industries is a leader in the flooring industry, and they are seeking a Director of Clinical & Pharmacy Strategy to lead the transformation of pharmacy and medical benefits management. This role involves developing and executing strategies to improve affordability and health outcomes for their associates while ensuring compliance with regulations.
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Responsibilities
Lead the end-to-end redesign of Shaw’s pharmacy benefit management (PBM) and medical plan strategy, ensuring alignment with organizational objectives, financial sustainability, and associate well-being
Develop and execute enterprise-level affordability strategies that integrate pharmacy, medical, and behavioral health data to identify trend drivers and create actionable solutions
Design evidence-based plan modifications, including formulary optimization, specialty drug management, and clinical policy pathways that improve efficiency and reduce spend
Serve as the company’s subject-matter expert in PBM contracting, plan design, and clinical policy; advise leadership on market trends, regulatory changes, and innovation opportunities
Provides strategic leadership and oversight for compliance with all medical and pharmacy benefit plans, ensuring adherence to federal, state, and regulatory requirements
Partner with team Analysts and Brokers to perform analyses of integrated claims and operational data (medical, pharmacy, lab, and authorizations) to identify cost and utilization trends, inform plan redesign, and evaluate vendor performance
Partner with data and finance teams to calculate self-funded cost projections, trend forecasts, and contribution models
Conduct competitor benchmarking and policy gap analyses to inform decision-making and ensure Shaw’s plans remain competitive and compliant
Track and monitor clinical policy performance metrics and recommend evidence-based modifications to improve affordability and associate health outcomes
Lead strategy and governance for Shaw’s PBM and medical carrier partners, ensuring performance excellence, transparency, and value
Evaluate and recommend alternative third-party solutions that support population health management, value-based care, and integrated wellbeing initiatives
Oversee renewals, RFPs, and negotiations with carriers and PBMs, including modeling financial impact and ensuring alignment with enterprise goals
Evaluate opportunities in specialty, ambulatory, infusion, and onsite pharmacy services, as well as carve-out models, to improve access and affordability
Integrate pharmacy and medical plan strategy with Shaw’s Onsite Clinics, behavioral health, and wellness programs for a unified Total Rewards experience
Develop and maintain partnerships with external experts, consultants, and industry groups to stay ahead of regulatory, innovation, and policy trends
Qualification
Required
Bachelor's degree in Business, Human Resources, Pharmacy, Health Administration, Public Health, or related field required
Minimum of 15 years of progressive experience in pharmacy benefit management, medical plan design, or healthcare strategy, with demonstrated leadership in PBM contracting and cost optimization
Deep knowledge of healthcare policy, compliance (ACA, ERISA, HIPAA)
Proven ability to conduct complex data analyses and translate findings into actionable recommendations for leadership
Exceptional communication and influencing skills; comfortable presenting to senior executives, finance leaders, and cross-functional partners
Hands-on operator with strong strategic acumen—able to balance long-term transformation with immediate execution
Demonstrated success managing large-scale projects, leading through ambiguity, and achieving measurable outcomes in affordability, access, and associate health
Limited travel necessary (likely two to four times annually)
High level of confidentiality
Preferred
Experience leading pharmacy carve-out evaluations, PBM transitions, or 340B program strategy
Background in self-funded plan management, value-based design, and integrated clinical analytics
Company
Shaw Industries
Shaw Industries Group, Inc.
10001+ employees
H1B Sponsorship
Shaw Industries has a track record of offering H1B sponsorships. Please note that this does not
guarantee sponsorship for this specific role. Below presents additional info for your
reference. (Data Powered by US Department of Labor)
Distribution of Different Job Fields Receiving Sponsorship
Represents job field similar to this job
Trends of Total Sponsorships
2024 (3)
2022 (1)
2021 (3)
2020 (2)
Funding
Current Stage
Late StageTotal Funding
unknown2001-01-08Acquired
Leadership Team
J
Jim Kirkpatrick
Executive Vice President and CFO
Recent News
2025-11-12
Company data provided by crunchbase