Strategic Pharmacist: Formulary & UM Leader

Highmark Health; Topeka (KS); Hybrid; USD 118,000 - 197,000; Full time

Job summary

Highmark Inc. seeks a Pharmacy Policy and Formulary Specialist to help develop and manage the organization’s formulary and utilization management programs in a hybrid work model (T, W, TH) for employees living within 50 miles of the corporate office.

The role involves evaluating FDA approvals, monitoring drug utilization, writing drug monographs for committee reviews, and supporting education initiatives for physicians, clients, and members.

Qualifications

• Understanding of managed care pharmacy principles and practices is essential.
• Strong verbal and written communication skills, and proficiency with data processing.
• Proficiency in Microsoft Office and database applications.
• Ability to identify and prioritize essential elements of problems.
• Ability to work independently or in a team to identify root issues and solutions.

Responsibilities

• Lead formulary and UM program initiatives to support cost savings.
• Develop drug formularies by monitoring FDA approvals and pipelines.
• Implement utilization management policies (prior authorization, dose edits, step therapy).
• Ensure compliance with state and federal regulatory requirements.
• Collaborate with analytics and external vendors to support pharmacy strategy.
• Provide guidance to junior staff and participate in cross-functional committees.
• Interact with manufacturers and PBMs to implement strategies.

Skills

Managed care pharmacy concepts

Verbal and written communication

Microsoft Office & databases

Problem identification & prioritizing

Root cause analysis & solutions

Education

Bachelor of Science in Pharmacy

Doctor of Pharmacy

Job description

Highmark Inc. seeks a Pharmacy Policy and Formulary Specialist to help develop and manage the organization’s formulary and utilization management programs in a hybrid work model (T, W, TH) for employees living within 50 miles of the corporate office.

The role involves evaluating FDA approvals, monitoring drug utilization, writing drug monographs for committee reviews, and supporting education initiatives for physicians, clients, and members.