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About the role
- Medicare Formulary Strategy Manager at Elevance Health leading formulary strategies and collaborating across teams. Ensuring compliance and optimizing for GRS formularies.
Responsibilities
- Lead the design, development, and execution of formulary strategies for all Group Retiree Solutions (GRS) formularies
- Collaborate with cross-functional partners
- Conduct competitive analyses, rebate optimization initiatives
- Provide formulary strategy support across Elevance Health’s MAPD business
- Oversee the Pharmacy & Therapeutics (P&T) and Value Assessment Committee (VAC) processes
- Partner with Actuarial teams to model financial scenarios
- Conduct ongoing and ad hoc reviews focused on specialty tiers
- Monitor emerging drug trends and utilization patterns
- Refine strategy based on real-time market intelligence
Requirements
- Requires BA/BS in Pharmacy
- Minimum of 2 years of managed care pharmacy experience
- Current valid active unrestricted state(s) RPH license required
- Advance degree preferred (PharmD, MBA, MPH, or equivalent)
- Minimum of 2 years of experience in pharmacy benefit management (PBM), Medicare Part D, or formulary management
- Strong understanding of CMS Part D formulary requirements and regulatory guidance
- Strong analytical, data interpretation, and trend management skills
- Knowledge of STARS measures and their application in formulary strategy
- Excellent communication and presentation skills
- Ability to synthesize clinical, financial, and regulatory insights into actionable strategies
- Strong analytical and problem-solving abilities
- Proven project management skills
Benefits
- Health insurance
- 401(k) matching
- Paid time off
- Flexible working arrangements
- Professional development opportunities
- Incentive and recognition programs
- Stock purchase plan
- Life insurance
- Wellness programs
- Financial education resources
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