Hybrid Medicare Formulary Strategy Manager

Posted 3 weeks ago

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About the role

  • 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

Job title

Medicare Formulary Strategy Manager

Job type

Experience level

JuniorMid level

Salary

$142,232 - $222,624 per year

Degree requirement

Bachelor's Degree

Location requirements

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