Remote Pharmacy Strategy & Formulary Lead

Highmark Health; Montpelier (VT); Hybrid; USD 118,000 - 197,000; Full time

Job summary

Highmark Inc. is seeking a Pharmacist for a hybrid role near the corporate office, contributing to formulary development, utilization management, and policy implementation. The role involves collaboration with physicians, clients, and vendors to improve patient outcomes and ensure regulatory compliance.

The position emphasizes mentorship of junior staff, support for educational initiatives, and active participation in cross-functional committees to advance pharmacy strategies and programs.

Qualifications

• An understanding of managed care pharmacy principles and practices is essential
• Demonstration of strong verbal and written communication skills, as well as proficiency in the use of computer-based data processing
• Microsoft Office products, and database applications

Responsibilities

• Lead formulary and UM program initiatives to support enterprise savings goals
• Assist in developing and implementing utilization management programs (prior authorization, dose/duration edits, quantity limits, step therapy)
• Ensure regulatory compliance for prescription drug benefits, formulary, and UM policies
• Collaborate with analytics and external vendors to generate real-world evidence for pharmacy strategy
• Peer-review medication reviews and other strategy deliverables
• Develop education initiatives for physicians, clients, and members about formulary and UM programs
• Manage department projects and drive process improvements
• Provide guidance to junior team members
• Perform other duties as assigned

Skills

Managed care pharmacy principles

Verbal and written communication

Microsoft Office

Database applications

Root cause analysis

Education

Bachelor of Science in Pharmacy or Doctor of Pharmacy

Job description

Highmark Inc. is seeking a Pharmacist for a hybrid role near the corporate office, contributing to formulary development, utilization management, and policy implementation. The role involves collaboration with physicians, clients, and vendors to improve patient outcomes and ensure regulatory compliance.

The position emphasizes mentorship of junior staff, support for educational initiatives, and active participation in cross-functional committees to advance pharmacy strategies and programs.