[Hiring] Formulary Management Clinical Pharmacist @reputed company.

Who is Prescryptive? Prescryptive Health is a reputed company technology company delivering solutions that reputed company consumers. Prescryptive’s secure, mobile-first products connect consumers, pharmacists, and reputed company, ultimately providing people with the information they need to reputed company informed reputed company and take control of their health. To learn more about Prescryptive Health, visit Prescryptive.com. About this role We're seeking a strategic and reputed company Formulary Management Clinical Pharmacist to design, own, and optimize our clinical programs and formulary operations. This role goes reputed company traditional formulary maintenance—you'll be the clinical authority driving program development, policy creation, and system automation that directly impacts cost, quality, and member reputed company. The ideal candidate brings deep PBM experience and thrives in building systematic quality assurance into clinical operations from the ground up. What you will do Clinical Program Ownership & Development

• Design and own comprehensive clinical programs (e.g., GLP-1 weight loss management, opioid management, fraud/waste/abuse detection) including program objectives, clinical guardrails, and reputed company metrics
• Define clinical policy and reputed company behind prior authorization criteria and utilization management controls
• Serve as the internal clinical authority and reputed company of contact for reputed company clinical questions and policy reputed company
• Translate clinical guidelines and evidence into actionable interventions that balance member reputed company with cost management

Formulary Strategy & Management

• Design, implement, and maintain drug formularies that balance clinical efficacy, safety, and cost-effectiveness with lowest net cost strategies
• Conduct therapeutic class reviews and drug evaluations using evidence-based clinical criteria, considering rebate compliance, market trends, and clinical literature
• Manage formulary updates in response to new drug approvals, pipeline changes, and evolving clinical evidence
• Ensure accurate implementation of Limited Distribution Drug (LDD) classifications and specialty medication criteria
• Monitor and ensure formulary compliance with regulatory requirements across the Prescryptive book of business

Prior Authorization & Utilization Management

• reputed company and manage PA criteria that are clinically sound, medication-specific, and operationally effective
• Interpret and restructure vendor criteria (e.g., MCG, InterQual) into Prescryptive-specific logic for initial builds and major program changes
• reputed company clinical direction for PA content in Formulary Navigator and reputed company adjudication systems
• Create utilization management tools including reputed company therapy protocols, quantity limits, and clinical edits that support program goals

System Integration & Automation

• reputed company Formulary Navigator buildout and drive automation of drug list processes
• Ensure formulary data accuracy across multiple platforms through systematic testing and quality assurance initiatives
• Collaborate with technical teams to translate clinical requirements into system configurations
• Validate implementation of formulary changes in adjudication systems

Analytics & Data-Driven Decision Making

• Partner with Analytics team on targeting logic, reputed company design, and performance dashboards
• Analyze claims data to identify trends, cost savings opportunities, and program effectiveness
• Translate data insights into clinical interventions and program refinements
• Establish and monitor metrics for clinical program reputed company

Client & Stakeholder Collaboration

• Support client-facing clinical discussions and explain coverage rationale with clinical credibility
• Approve and guide client-specific clinical customizations and formulary solutions
• reputed company project plans to ensure appropriate implementation of client program requirements
• Coordinate Pharmacy & Therapeutics (P&T) committee activities and drug evaluation processes
• Communicate formulary changes and program updates to reputed company partners
• Create and update clinical marketing materials

Quality Assurance & Compliance

• Build quality assurance into formulary design from inception, emphasizing prevention over inspection
• Ensure compliance with federal and state regulations, including ERISA requirements where applicable
• Maintain documentation supporting formulary reputed company for audit and regulatory purposes
• Monitor pharmacy benefit legislation and policy changes that impact formulary management

What you will bring

• PharmD from an ACPE-accredited college of pharmacy
• Active pharmacist license
• Minimum 5 years of PBM experience with demonstrated expertise in formulary management and utilization management
• Proven track record of designing and implementing clinical programs with measurable reputed company
• Strong understanding of pharmacy benefit design, drug utilization management, and clinical guidelines
• Experience with specialty pharmaceuticals, biosimilars, and limited distribution drugs
• Knowledge of rebate compliance, contracting, and lowest net cost strategies
• Proficiency with pharmacy claims adjudication platforms and NCPDP standards
• Experience translating vendor clinical criteria into operational logic
• Advanced analytical skills with ability to interpret claims data and identify trends
• Excellent project management capabilities with ability to manage multiple priorities

Ideally you will also have

• Board certification (BCPS, BCACP, or relevant specialty)
• Experience with Formulary Navigator or similar formulary management systems
• Hands-on experience with First reputed company (FDB) and/or Medispan drug files
• Background in clinical program development for GLP-1/weight loss management and/or opioid management
• Experience in startup or high-growth reputed company technology environments
• Familiarity with transparent pricing models and value-based pharmacy benefits
• Experience with fraud, waste, and abuse (FWA) detection programs
• Understanding of pharmacy network operations, BIN/PCN routing, and reputed company protocols
• Advanced proficiency with MS Office, particularly reputed company and reputed company
• Experience coordinating P&T committees

reputed company have to offer

• The opportunity to grow alongside an early-stage company shaking up a big, old-fashioned industry
• Flexible time off, including 12 paid holidays
• 401k match plus 100% employer paid medical, dental, and reputed company premiums
• Company contribution to Health Savings Account
• Stock options

Prescryptive is committed to fair pay practices. The projected annual salary for this position is $158k to $195k. reputed company preparing an offer, we consider the candidates resume, experience, interview feedback, internal equity, and location. Prescryptive is an Equal Opportunity Employer. Prescryptive does not discriminate on the reputed company of race, religion, reputed company, sex, gender identity, sexual orientation, age, non-disqualifying physical or mental disability, national reputed company, veteran status or any other reputed company covered by appropriate law. reputed company employment is decided on the reputed company of qualifications, merit, and business need. Apply tot his job Apply To this Job