Manager Formulary Design and Strategy
WFA Digital Insight
The demand for skilled pharmacy professionals has surged, with a 25% increase in job openings over the past year. As the healthcare landscape continues to evolve, pharmacists with expertise in formulary management are in high demand. CareSource, a leading healthcare organization, is seeking a seasoned Manager of Formulary Design and Strategy to drive innovative solutions. With a strong background in pharmacy and experience in managed care, candidates can leverage their skills to make a meaningful impact. Before applying, consider the importance of staying up-to-date on regulatory changes and industry trends in pharmacy benefits management.
Job Description
About the Role
The Manager of Formulary Design and Strategy plays a pivotal role in shaping CareSource's approach to pharmacy benefits management. This leader will oversee the development of formulary design best practices, ensuring that CareSource remains at the forefront of the industry. The role entails close collaboration with various stakeholders, including the Clinical Program Managers, to design and implement programs that drive better member health outcomes.As a key member of theCareSource team, the successful candidate will be responsible for managing the formulary management team, with a focus on execution, outcomes, and performance enhancement. The ability to analyze complex data, identify areas for improvement, and develop strategic solutions is essential. The role requires a deep understanding of the pharmaceutical industry, including the drug development pipeline and emerging trends in pharmacy benefits management.
The Manager of Formulary Design and Strategy will report to senior leadership and will be expected to provide expert guidance on formulary management and clinical policy development. This is an opportunity for a seasoned professional to make a significant impact on the organization and the lives of its members.
What You Will Do
- Lead the development of formulary design best practices and industry-leading formulary management strategies
- Manage the CareSource RXInnovations Value Assessment Committee, including preparation of meeting materials and presentations
- Direct the operational management of the formulary management team, with an emphasis on execution, outcomes, and performance enhancement
- Oversee the monitoring of the drug development pipeline and educate stakeholders on emerging trends and strategies
- Collaborate with business partners to ensure accurate and timely implementation of formulary changes
- Develop and report on key performance indicators (KPIs) related to formulary management
- Lead the identification, quantification, and measurement of total cost of care savings opportunities related to formulary management
- Collaborate with other teams to communicate and educate members, providers, pharmacies, and internal business partners on formulary and clinical policy initiatives
- Ensure regulatory and compliance guidelines are met for Medicaid, Medicare, Exchange, and other lines of business
- Analyze data to identify process improvement opportunities and develop strategic solutions
What We Are Looking For
- Bachelor's Degree in Pharmacy or PharmD required
- Minimum of five years of managed care experience, including at least two years of formulary management experience
- Experience participating in or leading a P&T, Value Assessment Committee, or Drug Utilization Review Board
- Previous management experience is required
- Strong proficiency in Microsoft Word, Outlook, PowerPoint, and Excel
- Excellent presentation and communication skills
- Ability to synthesize complex data and communicate findings effectively
- Strong problem-solving skills and attention to detail
- Experience working with multiple lines of business or multiple states is preferred
Nice to Have
- Master's in Business Administration or related field
- Experience with state-mandated formularies
- Familiarity with medical terminology and emerging trends in pharmacy benefits management
- Experience with project management and team leadership
Benefits and Perks
- Competitive salary and benefits package
- Opportunity to work with a leading healthcare organization
- Collaborative and dynamic work environment
- Professional development and growth opportunities
- Flexible work arrangements and remote work options
- Comprehensive health and wellness programs
- Generous paid time off and holiday schedule
How to Stand Out
- Develop a strong understanding of formulary management principles and industry trends to stand out as a candidate.
- Highlight your experience with data analysis and presentation, as these skills are essential for success in this role.
- Be prepared to discuss your approach to managing complex projects and leading cross-functional teams.
- Showcase your knowledge of regulatory guidelines and compliance requirements in pharmacy benefits management.
- Consider obtaining certifications, such as a Certified Pharmacy Benefits Manager (CPBM), to demonstrate your expertise and commitment to the field.
- Prepare to discuss your experience with managed care and pharmacy benefits management, including any experience with state-mandated formularies.
- Develop a portfolio of your work, including examples of formulary design and management strategies you have developed and implemented.
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