Pharmacist, Formulary Operations

Role Overview

• Provide oversight of clinical and medical management solutions for specialty drug management
• Ensure clinical quality and drive lowest net cost/high value approach while optimizing member experience
• Review and develop solutions for the management of all specialty drugs
• Participate in and provide oversight at clinical strategy team
• Present and participate in the quarterly P&T Meetings
• Implement and manage all downstream impact of decisions made by clinical strategy committee and rectified by P&T
• Oversee the creation and implementation of all prior authorization guidelines
• Provide guidance to evaluate and develop all clinical strategy team members
• Develop staffing models for all roles on team and recruit talent, hire, and train
• Participate operations of formulary/drug lists
• Oversee creation, implementation, and maintenance of all custom and standard drug lists
• Play an active role in the management of all new to market drugs and coordination with clinical strategy team
• Work cross-functionally with operations to implement all client builds
• Ensure all custom client requirements are reflected in the drug lists
• Ensure all clinical strategy initiatives are implemented accurately and on time
• Implement all clinical strategies with partner teams
• Provide clinical expertise on product development
• Ensure review and update of all prior authorization policies
• Participate in, adhere to, and support compliance, people and culture, and learning programs
• Perform other duties as assigned.

Requirements

• PharmD degree required
• Pharmacist license required
• 1+ years of pertinent experience required
• Specialty drug knowledge required
• Expert at Microsoft Office Suite required

Benefits

• Health insurance
• 401(k) matching
• Flexible work hours
• Paid time off
• Remote work options