Pharmacy Strategy Lead: Formulary & UM

Highmark Health; Trenton (NJ); Hybrid; USD 118,000 - 197,000; Full time

Job summary

Highmark Inc. in New Jersey is seeking a senior Pharmacy professional to lead formulary and utilization management strategy in a hybrid role near the corporate office. You will monitor FDA approvals, assess drug utilization, and write monographs for committee review.

The role involves developing prior authorization, dose and duration edits, quantity limits, and other UM tools, while collaborating with matrix partners and external vendors to advance clinical and operational pharmacy initiatives.

Qualifications

• 5 years of related, progressive experience in the pharmacy area of specialization OR PGY-1 residency plus 2 years of related experience.
• Preferred: experience in pharmacy strategy, formulary administration, or related programs.

Responsibilities

• Lead formulary and UM strategy development to support savings goals.
• Develop and implement prior authorization, dose/duration edits, and quantity limits.
• Monitor FDA approvals and drug manufacturer pipelines; write monographs.
• Ensure compliance with state and federal requirements in formulary management.
• Collaborate with internal/external stakeholders on education and policy initiatives.
• Mentor junior staff and participate in cross-functional committees.

Skills

Managed care pharmacy principles

Verbal & written communication

Computer-based data processing

Microsoft Office

Database applications

Education

BS Pharmacy or PharmD

Registered Pharmacist (Non-State Specific)

Tools

Microsoft Office

Database applications

Job description

Highmark Inc. in New Jersey is seeking a senior Pharmacy professional to lead formulary and utilization management strategy in a hybrid role near the corporate office. You will monitor FDA approvals, assess drug utilization, and write monographs for committee review.

The role involves developing prior authorization, dose and duration edits, quantity limits, and other UM tools, while collaborating with matrix partners and external vendors to advance clinical and operational pharmacy initiatives.