Pharmacy Director Formulary & Utilization Management

RIVERSIDE HOSPITAL SERVICES; Newport News (VA); On-site; USD 168,000 - 244,000; Full time

Job summary

Riverside Health System in Newport News, Virginia seeks a Director of Pharmacy Formulary & Utilization Management to provide enterprise leadership for formulary governance, utilization management, and cost-management strategies across the health system.

The role directs drug-use optimization, oversees high-cost therapies, and partners with pharmacy leadership, finance, and analytics to ensure safe, effective, and fiscally responsible medication use in both inpatient and outpatient settings.

Qualifications

• Bachelor's degree in Pharmacy required.
• 3 years of clinical pharmacy experience required.
• 2 years of leadership or supervisory experience required.
• 1 year PGY-1 residency required.
• 1 year PGY-2 residency preferred.

Responsibilities

• Provide enterprise leadership of formulary governance and systemwide implementation.
• Direct utilization management strategies and step-therapy protocols.
• Oversee high-cost therapeutic management and therapeutic reviews.
• Lead pharmacoeconomic analyses including budget impact and ROI.
• Monitor medication utilization and provide executive-level analytics.
• Collaborate with clinicians, supply chain, finance and analytics.
• Guide EMR formulary integrations and clinical decision support.

Skills

Formulary governance

Utilization management

Pharmacoeconomics

Leadership

Cross-functional collaboration

EMR integration

Budget/financial modeling

Cost management

Education

Bachelor's Degree in Pharmacy

PGY-1 Residency

PGY-2 Residency (Preferred)

Job description

Newport News, VirginiaHiring Range$168,300.00 - $244,050.00/Annual Actual pay is determined based on job-related factors such as relevant experience, education, credentials, skills, internal equity, and business needs.OverviewThe Director of Pharmacy Formulary & Utilization Management will provide enterprise leadership and strategic oversight for the health system's medication formulary, formulary management system and pharmacy utilization management programs. This position will direct systemwide formulary governance, therapeutic standardization, biosimilar adoption, drug-use optimization, and cost-management strategies in both inpatient and outpatient settings to ensure safe, evidence-based, and fiscally responsible medication use across the integrated delivery network. The Director will partner closely with pharmacy leadership, supply chain, analytics, medical staff, and service lines to drive consistency, financial stewardship, and high-quality medication management.What you will doProvides enterprise leadership of the system formulary and formulary management system, directing governance processes, evidence review standards, approval pathways, and systemwide implementation, while co-chairing the P&T Committee to ensure alignment with quality, clinical, and operational prioritiesLeads systemwide utilization management strategies, including development of drug-use criteria, therapeutic substitutions, and step-therapy protocols designed to optimize clinical appropriateness and reduce unwarranted variationOversees high-cost therapeutic management, guiding therapeutic class reviews, formulary monograph development, evidence evaluations, and interdisciplinary collaboration to improve access, care coordination, and value for complex and specialty therapiesDirects product and medication-use optimization initiatives, ensuring enterprise standardization of medication products, concentrations, and therapeutic interchange programs to enhance safety, efficiency, and consistency across the organizationProvides pharmacoeconomic leadership, conducting budget impact assessments, ROI analyses, and total-cost-of-care modeling to support formulary decisions and strategic planning for high-cost and emerging therapiesIdentifies and leads systemwide financial management initiatives aimed at reducing drug spend, improving therapeutic value, minimizing waste, and enhancing the financial performance of the pharmacy enterprise in collaboration with finance, reimbursement, and payer strategy teamsMonitors enterprise medication utilization and financial trends, leveraging analytics and benchmarking to identify opportunities, anticipate market shifts, evaluate medication mix, and deliver executive-level reporting on key indicators.Oversees formulary-related EMR integration and clinical decision support, ensuring medication builds, order sets, and CDS tools support safe prescribing, formulary compliance, high-cost drug management, and utilization management policiesProvides leadership, collaboration, and team oversight, fostering strong relationships with clinicians and operational partners, ensuring clear communication of formulary decisions and medication-use policies, and cultivating a culture of accountability, continuous improvement, and alignment with system priorities.QualificationsEducationBachelors Degree, or higher in Pharmacy (Required)Experience3 years Clinical Pharmacy experience (Required)2 years Leadership or Supervisory experience (Required)1 year PGY-1 Residency (Required)1 year PGY-2 Residency (Preferred)Skills and AbilitiesKnowledge of formulary governance and evidence-based drug evaluation, including class reviews and monograph developmentUnderstanding of utilization management strategies, such as drug-use criteria, therapeutic substitutions, and step therapyKnowledge of Pharmacoeconomics and financial modeling, including budget impact, ROI, and total-cost-of-care analysesSkill in medication and product standardization, including biosimilar adoption and therapeutic interchangeAbility to analyze utilization and financial data, using trends and benchmarks to guide decisionsKnowledge of EMR formulary integration and clinical decision support, including medication builds and order set alignmentAbility to lead cross-functional collaboration with clinicians, pharmacy leaders, supply chain, finance, and analyticsSkill in developing and communicating formulary policies and medication-use guidelinesAbility to drive performance and manage change across diverse care settingsStrong leadership and influence skills with the ability to guide governance processes and engage stakeholdersLicenses and CertificationsLicensed Pharmacist - Virginia Department of Health Professions (VDHP) within 60 Days(Required)Board of Pharmacy Specialties (BPS) - Board of Pharmacy Specialties within 2 Years(Required)To learn more about being a team member with Riverside Health System visit us at https://www.riversideonline.com/careers.