Clinical Formulary Management Pharmacist

This is a fully remote position, open to applicants in United States.

📋 Description

• Oversee formularies and clinical criteria for claims adjudication, prescription drug lists, websites, and associated publications.

• Engage in clinical and financial drug review committees.

• Conduct evaluations of drugs and drug classes, and formulate recommendations for formulary placement and utilization management.

• Investigate and articulate clinical and business factors related to drugs, drug categories, and formulary strategies.

• Offer subject matter expertise to address formulary-related issues.

• Track weekly drug files for new products and assign suitable drug statuses and formulary placements.

• Execute regular formulary quality assessments using reports and pharmacy data to identify and rectify discrepancies.

• Create and coordinate communications for members, clients, prescribers, pharmacies, and internal stakeholders regarding formulary modifications.

• Act as a liaison between clinical, operational, technical, client, and publishing teams.

• Maintain documentation and action items from committee meetings.

• Establish team procedures, checklists, and operational best practices.

• Carry out additional duties as assigned.

⛳️ Requirements

• PharmD or Bachelor's degree in Pharmacy.

• Minimum of 1 year of pharmacy experience in a retail, mail order, health plan, PBM, or comparable environment as a pharmacist.

• Valid Pharmacist license to practice in the relevant state(s).

• Must be authorized to work in the United States without requiring a work visa or residency sponsorship.

• Familiarity with prescription drugs, disease states, therapeutic classes, formulary management techniques, prescription benefit designs, and current healthcare industry trends.

• Strong project management, prioritization, and organizational abilities.

• Capability to meet tight turnaround times and handle deadline-driven tasks with minimal supervision.

• Exceptional written and verbal communication skills.

• Strong analytical and problem-solving skills, with keen attention to detail and quality.

• Ability to collaborate across teams while independently managing daily responsibilities.

• Quick learner of computer systems and software.

• Proficient in Microsoft Office Suite, including Word, Excel, and PowerPoint.

• Experience with health plans, PBMs, Managed Medicaid, formulary operations, drug review committees, or utilization management is preferred.

• Familiarity with formulary adjudication, clinical criteria implementation, prescription drug list publishing, or pharmacy data analysis is preferred.

• Experience with Microsoft Visio or Access is preferred.

• Must comprehend, adhere to, and affirm job-specific security responsibilities and controls.

• Must comply with all applicable legal, regulatory, contractual requirements, and internal policies and procedures.

🏝️ Benefits

• Benefits, incentives, and additional compensation (details available on the Benefits Page).

• Equal opportunity and affirmative action employer.

• Reasonable accommodations available for qualified applicants with disabilities.

• Tobacco-Free Workplace.