Strategic Pharmacist: Formulary & UM Leader

Highmark Health; Boise (ID); Hybrid; USD 118,000 - 197,000; Full time

Job summary

Highmark Inc. is seeking a Pharmacy professional to oversee formulary and utilization management initiatives, ensuring compliance with relevant regulations and optimizing patient outcomes.

The role involves collaboration with analytics teams and external vendors to drive evidence-based decisions. The position requires substantial experience in managed care pharmacy, strong communication skills, and the ability to lead cross-functional projects in a hybrid work environment.

Qualifications

• 5 years of related, progressive experience in the pharmacy area of specialization or completion of an accredited PGY-1 Managed Care Pharmacy Residency Program plus 2 additional years of related experience
• Bachelor of Science in Pharmacy or Doctor of Pharmacy degree required
• Experience with formulary development and utilization management is preferred

Responsibilities

• Lead formulary and utilization management strategy and development.
• Support regulatory compliance and audits for the Pharmacy & Therapeutics program.
• Partner with analytics and external vendors to generate real-world evidence for strategic decisions.
• Provide education and communication initiatives for physicians, clients, and members.
• Manage projects and mentor junior team members.

Skills

Managed care

Verbal & written communication

Data processing

Microsoft Office

Problem prioritization

Root cause analysis

Education

Bachelor of Science in Pharmacy or Doctor of Pharmacy

Tools

Database applications

Job description

Highmark Inc. is seeking a Pharmacy professional to oversee formulary and utilization management initiatives, ensuring compliance with relevant regulations and optimizing patient outcomes.

The role involves collaboration with analytics teams and external vendors to drive evidence-based decisions. The position requires substantial experience in managed care pharmacy, strong communication skills, and the ability to lead cross-functional projects in a hybrid work environment.