Pharmacy Formulary & Utilization Strategist

Highmark Health; Boston (MA); Hybrid; USD 118,000 - 197,000; Full time

Job summary

Highmark Inc. is seeking a pharmacist leader to develop and implement formulary and utilization management programs in a hybrid setting within 50 miles of the corporate office.

The role involves evaluating FDA approvals, drug pipelines, and utilization data, plus creating drug monographs and policy edits to improve patient outcomes within regulatory guidelines. You will collaborate with internal analytics, external vendors, and cross-functional teams to advance pharmacy strategies, educate

Qualifications

• Pharmacist degree and active licensure (non-state specific).
• Experience in managed care pharmacy preferred or residency with additional years in the field.
• Strong communication and collaboration skills required.

Responsibilities

• Lead formulary and UM program initiatives.
• Ensure compliance with state and federal requirements.
• Collaborate cross-functionally to develop and implement educational initiatives.
• Oversee program policies such as prior authorization, step therapies, and quantity limits.
• Provide guidance to junior team members and participate in audits.

Skills

Managed care

Verbal & written communication

MS Office & databases

Problem identification & prioritiz

Root cause analysis

Education

BS in Pharmacy or PharmD

Tools

Database applications

Job description

Highmark Inc. is seeking a pharmacist leader to develop and implement formulary and utilization management programs in a hybrid setting within 50 miles of the corporate office.

The role involves evaluating FDA approvals, drug pipelines, and utilization data, plus creating drug monographs and policy edits to improve patient outcomes within regulatory guidelines. You will collaborate with internal analytics, external vendors, and cross-functional teams to advance pharmacy strategies, educate