Clinical Pharmacist (Formulary & Quality)

Centene Corporation•Remote-IN, IN

2d•$107,700 - $199,300•Remote

About The Position

This is a remote opportunity for an Indiana-licensed Pharmacist working Monday through Friday on a daytime Eastern Time schedule. There are two open Clinical Pharmacist positions that support Indiana Medicaid pharmacy operations through either a Formulary & Policy focus or a Quality & Clinical Programs focus, with opportunities for collaboration and cross-coverage between the roles. Responsibilities include leading formulary, prior authorization, and clinical policy initiatives; supporting quality improvement and medication-related clinical programs; analyzing pharmacy and performance data; developing policies, workflows, educational materials, and communications; and partnering with cross-functional teams, providers, and vendors to implement state-driven and quality-focused initiatives. The ideal candidate will have experience in managed care, Medicaid, health plans, PBMs, formulary management, prior authorization, quality improvement, specialty drug management and/or population health and demonstrate strong clinical judgment, written communication, project management, data analysis, and collaboration skills. Success in this role requires the ability to manage competing priorities, translate complex requirements into actionable solutions, identify risks, and consistently deliver accurate, audit-ready work. This opportunity offers meaningful ownership, visibility, and the chance to directly impact member access, medication safety, quality outcomes, and regulatory compliance within Indiana Medicaid pharmacy programs.

Requirements

Current Indiana Pharmacist license with no restrictions.
Bachelor’s degree or advanced degree (Pharm.D., M.S.) in pharmacy.
2+ years of mail order, retail, hospital or managed care pharmacy experience or 1+ years of pharmacy residency program experience.
Managed care, Medicaid, health plans, PBMs, formulary management, prior authorization, quality improvement, specialty drug management and/or population health experience.
Strong clinical judgment, written communication, project management, data analysis, and collaboration skills.
Ability to manage competing priorities, translate complex requirements into actionable solutions, identify risks, and consistently deliver accurate, audit-ready work.

Nice To Haves

Specialty drug management experience, preferred

Responsibilities

Define and develop standard and custom formularies for assigned plan.
Develop clinical criteria for medications, recommend plan design changes, and clinical programs to be initiated
Monitor prior authorization requests
Provide clinical support to internal departments and address clinical related questions
Ensure appropriate quality controls and initiates opportunities for performance improvement in pharmacy/practice
Develop and implement programs designed to impact DUR for both Medicaid and Medicare
Develop, implement, and maintain policies and procedures for the pharmacy department
Participate in the coordination of the Medicare MTM program
Assist case management team with members including clinical rounds presentations