Clinical Pharmacist IV: Formulary & UM Strategy (Hybrid)

Medica Services Company LLC; Minnetonka (MN); Hybrid; USD 113,000 - 194,000; Full time

Job summary

Medica is seeking a Clinical Pharmacist IV – Formulary Management to join our Minnesota team. In this hybrid role based in Minnetonka, MN, you will drive formulary strategy, UM, and P&T support across a large health plan.

You will analyze literature, develop monographs, and collaborate with analytics to optimize therapies and spend. Strong knowledge of PBM, regulatory compliance, and stakeholder communication is essential.

Qualifications

• Bachelor’s Degree, PharmD, or equivalent experience in a related field.
• 5+ years of progressive clinical pharmacy experience, with significant experience in managed care, health plan, PBM, or payer-aligned environments.
• Prior experience with Pharmacy and Therapeutics committee processes/formulary management at a health plan or Pharmacy Benefit Manager (PBM).
• Strong knowledge of pharmacy benefit management, formulary execution, clinical pharmacy programs, pharmacy utilization, and the factors that influence pharmacy spend and trend.

Responsibilities

• Monitor and assess the pharmaceutical drug pipeline, proactively identify key emerging therapies, and partner with analytics to forecast utilization and financial impacts.
• Evaluate clinical literature to develop drug monographs, therapeutic class evaluations, and formulary and utilization management (UM) recommendations to drive P&T committee decision making.
• Partner with internal clinical pharmacy team and analytics support to analyze pharmacy trends, identify formulary and UM opportunities, and develop strategies to support continuous improvement in formulary and UM outcomes.
• Develop and promote clinical formulary initiatives such as biosimilar optimization, market differentiation strategies, and other enterprise pharmacy programs.
• Actively participate in internal and external clinical pharmacy meetings, workgroups, and cross-functional initiatives necessary to advance strategic, operational, and performance objectives.
• Oversees and partners with key stakeholders on formulary management, clinical programs, operations, regulatory and compliance needs.
• Serves as clinical pharmacy subject matter expert and advisor.

Skills

Clinical pharmacy experience

Managed care experience

Healthcare analytics understanding

Regulatory compliance knowledge

Education

Bachelor’s Degree

PharmD

Job description

Medica is seeking a Clinical Pharmacist IV – Formulary Management to join our Minnesota team. In this hybrid role based in Minnetonka, MN, you will drive formulary strategy, UM, and P&T support across a large health plan.

You will analyze literature, develop monographs, and collaborate with analytics to optimize therapies and spend. Strong knowledge of PBM, regulatory compliance, and stakeholder communication is essential.