Senior Manager, Clinical Pharmacy

Limelight Health; Minneapolis (MN); On-site; USD 150,000 - 190,000; Full time

Benefits offered by this job

Parental leave (up to 16 weeks)?

401k program

Transportation perks

Education reimbursement

Paw-ternity leave

Job summary

Gravie seeks a strategic, hands-on pharmacy leader to own clinical oversight of our PBM and pharmacy vendors, driving formulary strategy and clinical programs that improve affordability and member outcomes.

This role blends clinical expertise with operational execution, partnering with actuarial, finance and product teams to inform pricing, spend forecasting, and stop-loss considerations across the organization.

Qualifications

• PharmD degree and active, unrestricted pharmacist license required.
• 5+ years of pharmacy experience in clinical operations, utilization management, or formulary leadership.
• Demonstrated experience in contracting oversight or performance evaluation with PBMs or pharmacy vendors.
• Bonus: experience with commercial level-funded health plans and/or innovative health insurers.

Responsibilities

• Serve as the primary pharmacy clinical lead for our PBM partnership, including oversight of utilization management, formulary and clinical programs.
• Design, implement and manage clinical programs that drive affordability, quality, and member outcomes.
• Provide clinical oversight of pharmacy vendors and clinical programs that improve outcomes and reduce unnecessary utilization.
• Own formulary design and maintenance, including tier strategy, drug placement, therapeutic class management, and clinical edit logic.
• Complete reviews of prior authorization decisions and appeals for specialty and non-specialty drugs.
• Develop and maintain policies related to clinical pharmacy and both pharmacy and medical benefit drugs.
• Collaborate with actuarial, finance, and product teams to inform pricing, trend modeling, pharmacy spend forecasting, and stop-loss considerations.
• Partner cross-functionally with product, clinical, network, actuarial and other stakeholders to ensure integrated care approaches.
• Ensure compliance with applicable regulatory, accreditation, and clinical governance standards, maintaining high ethical and quality standards.

Skills

Strategic leadership

Cross-functional collaboration

Clinical leadership

Education

PharmD degree

Active pharmacist license

Job description

Hi, we’re Gravie. Our mission is to create health benefits that actually benefit small and midsize businesses and their employees. Our innovative benefit solutions and services are developed and delivered by a diverse group of unique people. We encourage you to be your authentic self - we like you that way.

We’re seeking a strategic, hands-on pharmacy leader to own clinical oversight of our PBM and pharmacy vendors, drive formulary and UM strategy, and provide clinical expertise to shape our pharmacy affordability programs. This role bridges clinical expertise and operational execution to drive sustainable pharmacy spend and strong member outcomes.

Key Responsibilities

• Serve as the primary pharmacy clinical lead for our PBM partnership, including oversight of utilization management, formulary and clinical programs
• Design, implement and manage clinical programs that drive affordability, quality, and member outcomes
• Provide clinical oversight of pharmacy vendors and clinical programs that improve outcomes and reduce unnecessary utilization
• Own formulary design and maintenance, including tier strategy, drug placement, therapeutic class management, and clinical edit logic
• Complete reviews of prior authorization decisions and appeals for specialty and non-specialty drugs
• Develop and maintain policies related to clinical pharmacy and both pharmacy and medical benefit drugs
• Collaborate with actuarial, finance, and product teams to inform pricing, trend modeling, pharmacy spend forecasting, and stop-loss considerations
• Partner cross-functionally with product, clinical, network, actuarial and other stakeholders to ensure integrated care approaches
• Ensure compliance with applicable regulatory, accreditation, and clinical governance standards, maintaining high ethical and quality standards

Key Requirements

• PharmD degree and active, unrestricted pharmacist license required
• 5+ years of pharmacy experience in clinical operations, utilization management, or formulary leadership
• Demonstrated experience in contracting oversight or performance evaluation with PBMs or pharmacy vendors
• (Bonus) Experience working within commercial level-funded health plans and/or innovative health insurers (e.g., startup or growth-stage plans)

A Little More About Us:

• We know healthcare. Our company was founded and is still led by industry veterans who have started and grown several market-leading companies in the space.
• We have raised money from top tier investors who share the same long-term vision as we do of building an industry defining company that will endure over the long run. We are well capitalized.
• Our clients love us. Customer satisfaction rates among employees using Gravie health plans consistently rank above 80% – nearly 40 points above the industry average.
• Our culture is unique. We tend to be non-hierarchical, merit-driven, opinionated but kind people who thrive working in a high-performance, fast-paced environment. People at Gravie care deeply about making a positive impact in the lives of the people we serve.

Benefits

Our unique benefits program is the gravy, i.e., the special sauce that sets our compensation package apart. In addition to standard health and wellness benefits, Gravie’s package includes alternative medicine coverage, flexible PTO, up to 16 weeks paid parental leave, paid holidays, a 401k program, transportation perks, education reimbursement, and 2 days of paid paw-ternity leave.

Job Applicants

If you apply for employment with Gravie, personal information collected via our applicant tracking vendor is subject to our standalone California Job Applicant Notice at Collection, accessible directly within the application workflow and separate from this Policy.