Strategic Clinical Pharmacist — Formulary & UM Lead

Medica; Hopkins (MN); On-site; USD 113,000 - 170,000; Full time

Benefits offered by this job

Medical benefits

Dental benefits

Vision benefits

PTO

Holidays

Paid volunteer time off

401K contributions

Caregiver services

Job summary

Medica is a nonprofit health plan seeking a Clinical Pharmacist to drive formulary strategy, utilization management, and clinical programs in partnership with internal teams and external stakeholders.

This onsite role, based in Minnesota, requires close collaboration with the Pharmacy & Therapeutics process and PBM landscape to optimize patient care and cost efficiency while ensuring regulatory compliance.

Qualifications

• Bachelor's degree, PharmD, or equivalent experience in a related field.
• 5+ years of progressive clinical pharmacy experience in managed care, PBM, or payer environments.
• Active Pharmacist License.

Responsibilities

• Monitor and assess the pharmaceutical drug pipeline and forecast utilization and financial impact.
• Evaluate literature to develop drug monographs, therapeutic class evaluations, and UM recommendations.
• Partner with internal clinical pharmacy team to analyze trends and develop formulary/UM opportunities.
• Develop and promote clinical formulary initiatives such as biosimilar optimization and other enterprise pharmacy programs.
• Participate in internal/external clinical pharmacy meetings and cross-functional initiatives.
• Oversee formulary management, clinical programs, operations, regulatory and compliance needs.
• Serve as clinical pharmacy subject matter expert and advisor.

Skills

Regulatory knowledge

Stakeholder collaboration

Analytical skills

Communication

Education

Bachelor's degree, PharmD, or equivalent

Tools

Pharmacy data analytics tools

PBM knowledge

Job description

Medica is a nonprofit health plan seeking a Clinical Pharmacist to drive formulary strategy, utilization management, and clinical programs in partnership with internal teams and external stakeholders.

This onsite role, based in Minnesota, requires close collaboration with the Pharmacy & Therapeutics process and PBM landscape to optimize patient care and cost efficiency while ensuring regulatory compliance.