Remote Director, Formulary & Utilization Strategy

TalentLNX; Northern (KY); Hybrid; USD 165,000 - 200,000; Full time

Job summary

TalentLNX is seeking a Director, Formulary and Utilization Management to lead PBM-wide formulary strategy, utilization management program design, and specialty pharmacy initiatives. This remote, US-based role requires an experienced pharmacy leader with deep managed care knowledge to drive P&T activities, prior authorization programs, and evidence-based coverage decisions.

You will shape biosimilar strategy, site-of-care optimization, and regulatory-aligned formulary governance, partnering with

Qualifications

• PharmD from ACPE-accredited school is required.
• MD or DO considered with equivalent managed care leadership experience.
• Active, unrestricted pharmacist license required.
• 5+ years in formulary management, PBM, or managed care leadership.

Responsibilities

• Lead Pharmacy and Therapeutics Committee activities, including reviews of new meds and formulary optimization.
• Develop and oversee utilization management programs (prior authorization, step therapy).
• Direct specialty pharmacy strategy and biosimilar management.
• Collaborate with compliance, regulatory, and medical leadership on CMS Part D and Medicaid requirements.
• Oversee pharma quality initiatives tied to HEDIS, Stars, and medication adherence.

Skills

Leadership

Communication

Cross-functional work

Clinical evidence assessment

Education

PharmD (ACPE)

MD/DO considered

Job description

TalentLNX is seeking a Director, Formulary and Utilization Management to lead PBM-wide formulary strategy, utilization management program design, and specialty pharmacy initiatives. This remote, US-based role requires an experienced pharmacy leader with deep managed care knowledge to drive P&T activities, prior authorization programs, and evidence-based coverage decisions.

You will shape biosimilar strategy, site-of-care optimization, and regulatory-aligned formulary governance, partnering with