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Highmark Health
Highmark Health
H1B Visa SponsorConsultingInsuranceLogistics
Highmark Health is a healthcare organization focused on improving how people experience and access care. Its work spans clinical services, technology, finance, marketing, and other functions that support the delivery of healthcare. As an independent licensee of the Blue Cross Blue Shield Association, the company brings together a broad range of professionals to help evolve the healthcare system. Highmark Health also highlights diversity, equity, and inclusion, with recognition for disability inclusion and military-friendly employment.
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Senior Pharmacist, Strategy - Hybrid

Senior Pharmacist leading formulary development and pharmacy utilization-management strategy for Highmark Health’s insurance programs. The role evaluates drug evidence, supports regulatory compliance, and advances pharmacy initiatives.

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$118,400 – $196,800 / year
HybridFull-timeSeniorEnglish RequiredPharmacist

Description

  • Track FDA approvals, manufacturer pipelines, and drug utilization reports
  • Create and implement formularies and pharmacy utilization-management policies
  • Prepare drug monographs for Pharmacy & Therapeutics Committee review
  • Design and implement prior authorization, dose and duration edits, quantity limits, step therapy, generic sampling, and pharmacy policy programs
  • Ensure compliance with federal, state, and other applicable mandates
  • Create educational initiatives for physicians, pharmacies, clients, and members
  • Serve on cross-functional committees and collaborate with analytics teams, pharmacy vendors, matrix partners, and other stakeholders
  • Engage with pharmaceutical manufacturers, pharmacy benefit managers, and strategic partners
  • Assess, implement, and monitor legislation affecting pharmacy benefits
  • Plan, execute, and track pharmacy-focused strategic initiatives
  • Present recommendations to organizational leadership
  • Peer-review medication reviews, utilization-management policies, and strategy deliverables
  • Identify opportunities for departmental process improvement and support their implementation
  • Lead assigned projects and provide guidance to junior team members

Requirements

  • At least five years of related, progressive pharmacy experience, or an accredited PGY-1 Managed Care Pharmacy Residency plus two additional years of related, progressive experience
  • Bachelor of Science in Pharmacy or Doctor of Pharmacy degree
  • Registered Pharmacist credential, non-state specific
  • Knowledge of managed-care pharmacy principles and practices
  • Strong written and verbal communication abilities
  • Proficiency in computer-based data processing
  • Working knowledge of Microsoft Office and database applications
  • Ability to isolate and prioritize the essential elements of complex problems
  • Ability to determine root causes and develop potential solutions independently or collaboratively
  • Compliance with HIPAA, data-security guidelines, the Code of Business Conduct, applicable laws and regulations, company policies, and required training

Benefits

  • Hybrid work model for employees living within 50 miles of the corporate office
  • Remote work option
  • Less than 25% travel required

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