Gravie - Senior Manager, Clinical Pharmacy
Requirements
• ● PharmD degree and active, unrestricted pharmacist license required • ● 5+ years of pharmacy experience in clinical operations, utilization management, or formulary leadership • ● Demonstrated experience in contracting oversight or performance evaluation with PBMs or pharmacy vendors • ● Experience working within commercial level-funded health plans and/or innovative health insurers (e.g., startup or growth-stage plans) • In order to transform health insurance and build a health plan everyone can love, we need talented people doing amazing work. In exchange, we offer a great overall employee experience with opportunities for career growth, meaningful mission-driven work, and an above average total rewards package. • The salary range for this position is $142,500 - $237,500 annually. Numerous factors including, but not limited to, educations, skills, work experience, certifications, etc. will be considered when determining compensation. • Our unique benefits program is the gravy, i.e., the special sauce that sets our compensation package apart. In addition to standard health and wellness benefits, Gravie’s package includes alternative medicine coverage, flexible PTO, up to 16 weeks paid parental leave, paid holidays, a 401k program, cell phone reimbursement, transportation perks, education reimbursement, and 1 week of paid paw-ternity leave.
Responsibilities
• ● Serve as the primary pharmacy clinical lead for our PBM partnership, including oversight of utilization management, formulary and clinical programs • ● Design, implement and manage clinical programs that drive affordability, quality, and member outcomes • ● Provide clinical oversight of pharmacy vendors and clinical programs that improve outcomes and reduce unnecessary utilization • ● Own formulary design and maintenance, including tier strategy, drug placement, therapeutic class management, and clinical edit logic • ● Complete reviews of prior authorization decisions and appeals for specialty and non-specialty drugs • ● Develop and maintain policies related to clinical pharmacy and both pharmacy and medical benefit drugs • ● Collaborate with actuarial, finance, and product teams to inform pricing, trend modeling, pharmacy spend forecasting, and stop-loss considerations • ● Partner cross-functionally with product, clinical, network, actuarial and other stakeholders to ensure integrated care approaches • ● Ensure compliance with applicable regulatory, accreditation, and clinical governance standards, maintaining high ethical and quality standards
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