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pbm regulatory compliance formulary pharmacy_vendors📋 Description
- Lead PBM partnership as clinical lead; oversee utilization mgmt and formulary programs
- Design and manage clinical programs that improve affordability, quality, outcomes
- Provide clinical oversight of pharmacy vendors and programs to improve outcomes
- Own formulary design and maintenance: tiers, drug placement, class mgmt
- Complete reviews of prior authorization decisions for specialty and non-specialty drugs
- Collaborate with actuarial, finance, and product to inform pricing and spending trends
🎯 Requirements
- PharmD degree and active, unrestricted pharmacist license required
- 5+ years in clinical ops, utilization management, or formulary leadership
- Experience contracting with PBMs or pharmacy vendors
- Extra credit: experience with commercial level-funded plans or innovative insurers
🎁 Benefits
- Flexible PTO
- Up to 16 weeks paid parental leave
- Paid holidays
- 401k program
- Cell phone reimbursement
- Transportation perks
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