Pharmacy Strategy Lead - Formulary & UM

Highmark; United States; Hybrid; USD 118,000 - 197,000; Full time

Job summary

Highmark Inc. is seeking a senior Pharmacist to lead formulary development and utilization management, operating in a hybrid model within 50 miles of the corporate office.

The role emphasizes FDA-driven drug evaluation, policy execution, and compliance with federal and state mandates to improve member outcomes. The position requires 5 years of pharmacy experience (or PGY-1 plus 2 years), licensure as a Pharmacist, and strong collaboration with analytics, physicians, and vendors.

Qualifications

• 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 experience
• Pharmacist licensure (Registered Pharmacist) is required
• Board Certified Pharmacotherapy Specialist and Board Certified Geriatric Pharmacist credentials are preferred

Responsibilities

• Develop formulary and utilization management (UM) program initiatives supporting enterprise goals
• Monitor FDA approvals and drug manufacturer pipelines; write drug monographs for committee review
• Implement and oversee UM programs: prior authorization, dose/duration edits, quantity limits, step therapy, generic sampling
• Ensure regulatory compliance and oversee formulary administration per state/federal requirements
• Educate physicians, clients, and members about pharmacy strategies and initiatives
• Collaborate with cross-functional teams and external vendors to improve outcomes

Skills

Managed care knowledge

Communication skills

MS Office / databases

Data analysis

Team collaboration

Education

Bachelor of Science in Pharmacy or Doctor of Pharmacy

Job description

Highmark Inc. is seeking a senior Pharmacist to lead formulary development and utilization management, operating in a hybrid model within 50 miles of the corporate office.

The role emphasizes FDA-driven drug evaluation, policy execution, and compliance with federal and state mandates to improve member outcomes. The position requires 5 years of pharmacy experience (or PGY-1 plus 2 years), licensure as a Pharmacist, and strong collaboration with analytics, physicians, and vendors.