Pharmacy Strategy Lead - Formulary & Utilization

Highmark Health; Honolulu (HI); Hybrid; USD 118,000 - 197,000; Full time

Job summary

Highmark Health seeks a senior leader to guide formulary development and utilization management, ensuring compliance with regulatory standards and advancing pharmacy strategies. You will collaborate with analytics and vendors to generate evidence and support program goals.

The role involves educating stakeholders, mentoring staff, and driving cross-functional initiatives to optimize member outcomes and cost-savings in a hybrid model within 50 miles of the corporate office.

Qualifications

• An understanding of managed care pharmacy principles and practices is essential.
• Strong verbal and written communication skills and proficiency with computer-based data processing.
• Proficiency with Microsoft Office products and database applications.
• Able to quickly identify and prioritize essential elements of problems.
• Able to identify root issues independently or in a team and formulate solutions.

Responsibilities

• Lead and support formulary and UM program strategy and development.
• Ensure regulatory compliance related to prescription drug benefits and formulary management.
• Collaborate with internal analytics and external vendors to generate real-world evidence.
• Oversee and review pharmacy reviews, policies, and program deliverables.
• Educate physicians, clients, and members on pharmacy strategies and programs.
• Manage department projects and drive process improvements.
• Mentor junior team members and support cross-functional initiatives.

Skills

Managed care

Communication

Data processing

MS Office

Problem solving

Teamwork

Education

BS in Pharmacy or PharmD

Tools

Microsoft Office

Database applications

Job description

Highmark Health seeks a senior leader to guide formulary development and utilization management, ensuring compliance with regulatory standards and advancing pharmacy strategies. You will collaborate with analytics and vendors to generate evidence and support program goals.

The role involves educating stakeholders, mentoring staff, and driving cross-functional initiatives to optimize member outcomes and cost-savings in a hybrid model within 50 miles of the corporate office.