Preferred Drug List Pharmacist

🔥 0 minutes ago

🚗 Michigan – Remote

🚗 Michigan – Remote

💵 $113.7k - $162.4k / year

⏰ Full Time

🟡 Mid-level

🟠 Senior

💊 Pharmacist

🦅 H1B Visa Sponsor

This company has sponsored H1B visas in the past.

👻 Ghost score 0%

What it means: the chance that no one is really hiring for this job.How to read it: 60% or higher means we think this is a ghost. Lower scores are less of a worry.How we score it: age, reposts, open roles vs team size, how fast jobs close, and whether pay is listed.Fine print: an estimate from public data, not a judgment of the company. Real jobs can score high, so treat it as a hint, not a fact.

Apply Now

Find Similar Remote Jobs

Gainwell Technologies

WebsiteLinkedInAll Job Openings

10,000+ employees

💼 Consulting

📦 Logistics

⚕️ Healthcare Insurance

💰 Grant on 2023-06

Consulting • Logistics • Healthcare Insurance

Gainwell Technologies is the nation’s leading provider of digital and cloud-enabled solutions across the human services and public health ecosystem. With a mission-driven approach, Gainwell serves clients in all 50 U. S. states, focusing on improving health outcomes and delivering intuitive, human-centered experiences. Their comprehensive suite of solutions includes Medicaid Enterprise modernization, data analytics, provider services, and pharmacy solutions, all designed to advance the future of healthcare and enhance community well-being.

📋 Description

• Support the clinical, operational, and financial Preferred Drug List needs of the Delaware Medicaid Fee-for-Service line of business • Oversee development, implementation, maintenance, and expansion of a clinically appropriate and fiscally responsible PDL • Ensure adjudication and related communications reflect current program requirements • Monitor drug market changes, launches, generics, biosimilars, discontinuations, pricing, shortages, patent expirations, and Medicaid Drug Rebate Program changes • Develop and maintain prior authorization criteria, drug coding and status files, therapeutic class reviews, publications, and Pharmacy & Therapeutics Committee materials • Analyze clinical evidence, utilization, market share, net cost, and rebate considerations • Develop strategic recommendations for drug coverage, therapeutic classes, and utilization management • Serve as primary Delaware contact and subject matter expert for PDL maintenance, development, expansion, and transformation • Present clinical and financial recommendations to clients and Pharmacy & Therapeutics Committee stakeholders • Coordinate across clinical, account, pharmacy, and other internal and external teams • Drive continuous improvement of PDL operations and financial programs, including value-based and volume-based agreements, Brand over Generic, and preferred diabetic supply programs • Support the Gainwell Pharmacy Center of Excellence

🎯 Requirements

• Active, unrestricted Registered Pharmacist license in any state • PharmD or equivalent education and experience • At least three years of pharmacy benefits management or managed care experience • Knowledge of Medicaid at the state and/or federal level • Experience working in Medicaid, healthcare technology, and/or pharmacy analytics • Experience supporting Pharmacy & Therapeutics Committee and Drug Utilization Review Board activities • Experience managing formularies from clinical, operational, and financial perspectives • Strong analytical, client relationship, communication, and technology skills • Ability to translate complex clinical and business information into actionable recommendations • Ability to work Eastern Time Zone hours • Maintain confidentiality and comply with HIPAA and applicable Gainwell policies • Maintain regular attendance and effective working relationships with coworkers, clients, members, providers, and customers

🏖️ Benefits

• Flexible hours • Work-life balance • Continuous learning and career development • Generous, flexible vacation policy • 401(k) employer match • Comprehensive health benefits • Educational assistance • Leadership and technical development academies • Work flexibility

📊 Check your resume score for this job

Improve your chances of getting an interview by checking your resume score before you apply.

Upload Resume