Senior Pharmacist - Strategy
About The Position
This role develops and executes the organization’s drug formulary and pharmacy utilization management policies while monitoring FDA approvals, drug manufacturer pipelines, and drug utilization reports. The Senior Pharmacist supports evidence-based drug evaluation, formulary strategy, and pharmacy programs, and helps maintain compliance with applicable federal, state, and other requirements. Work may include preparing drug monographs for committee review and developing and implementing programs such as prior authorization, dose and duration edits, quantity limits, step therapy edits, generic sampling, and pharmacy policy review. The role also supports review of member-specific information to improve individual outcomes. The position collaborates with internal teams, analytics partners, pharmacy vendors, pharmaceutical manufacturers, the pharmacy benefit manager, and strategic partners, as applicable. It contributes to clinical and operational initiatives, educational programs for physicians, pharmacies, clients, and members, regulatory oversight, quality review, project management, process improvement, and strategic initiatives. The Senior Pharmacist may provide guidance to junior team members and present recommendations to leadership. The role operates in a hybrid model (Tuesday, Wednesday, and Thursday) for employees residing within 50 miles of the corporate office. The position is described as office-based or remote, with the physical work site required frequently. Travel is less than 25%.
Requirements
- At least 5 years of related, progressive experience in the pharmacy area of specialization, or completion of an accredited PGY-1 Managed Care Pharmacy Residency Program plus 2 additional years of related, progressive experience in the pharmacy area of specialization.
- Bachelor of Science in Pharmacy or Doctor of Pharmacy degree.
- Registered Pharmacist (Non-State Specific) license or certification.
- Understanding of managed care pharmacy principles and practices.
- Strong verbal and written communication skills.
- Proficiency in computer-based data processing.
- Ability to use Microsoft Office products and database applications.
- Ability to quickly identify and prioritize essential elements of a problem.
- Ability to identify root issues and formulate potential solutions independently or as part of a team.
Nice To Haves
- Progressive experience in pharmacy strategy, formulary administration, or pharmacy program or product development within a health system, health plan, or pharmacy benefit manager setting.
- Board Certified Pharmacotherapy Specialist.
- Board Certified Geriatric Pharmacist.
Responsibilities
- May lead the evidence-based medicine drug evaluation program supporting formulary, utilization management, and pharmacy program strategy.
- Develop pharmacy formulary and utilization management initiatives that support enterprise customer value creation savings goals.
- Monitor FDA approvals and drug manufacturer pipelines and assess drug utilization reports to assist with drug formulary development.
- Write drug monographs for Pharmacy & Therapeutics Committee review, as applicable.
- Assist in developing and implementing utilization management programs, including prior authorization, dose and duration edits, quantity limits, step therapy edits, generic sampling, pharmacy policy review and development, and review of member-specific information.
- Execute the Pharmacy & Therapeutics Committee charter and support program compliance with regulatory standards.
- Support regulatory compliance for prescription drug benefits, formularies, and pharmacy utilization management policies.
- Manage formulary administration and oversight to ensure compliance with applicable state and federal requirements.
- May represent Highmark in applicable state or federal audits.
- May partner with internal analytics teams and external pharmacy vendors to generate real-world evidence insights supporting pharmacy strategy.
- Participate in cross-functional committees to develop and implement clinical and operational initiatives focused on pharmacy.
- Peer-review medication reviews, pharmacy utilization management policies, and other strategy deliverables, as applicable.
- Develop and implement educational initiatives for physicians, pharmacies, clients, and members that promote pharmacy strategies and programs.
- Identify and assist in managing department process improvements to maximize efficiency.
- Manage individual projects for timely review with leadership.
- Provide guidance to more junior team members.
- Perform other duties as assigned or requested.
Stand Out From the Crowd
Upload your resume and get instant feedback on how well it matches this job.
What This Job Offers
Job Type
Full-time
Career Level
Senior
