Formulary Manager at WellDyne

Centennial, Colorado, United States -

Full Time

Start Date

Immediate

Expiry Date

29 Jul, 26

Salary

0.0

Posted On

30 Apr, 26

Experience

5 year(s) or above

Remote Job

Yes

Telecommute

Yes

Sponsor Visa

Skills

Formulary management, Clinical pharmacy, Utilization management, Prior authorization, Step therapy, Pharmacy claims analysis, Data analysis, Pharmacology, Pharmacy benefits, MS Excel, Regulatory compliance, P&T committee support, Drug trend analysis, Clinical operations

Industry

Hospitals and Health Care

Description

At our company, we move fast, adapt quickly, and turn challenges into opportunities—all while keeping quality at the heart of everything we do. We believe that work should be a positive and respectful place, and that with the right mindset, anything is achievable. Our Vision: Fulfill the essential promise of pharmacy care and help people to live to their healthiest, happiest, and fullest potential. Our Mission: To be the disruptive force that drives meaningful change within pharmacy services. Summary The Formulary Manager designs, maintains, and updates prescription drug lists to balance cost-effectiveness with clinical efficacy. They analyze drug trends and implement utilization management (e.g., prior authorization, step therapy, etc.). This role ensures compliant, cost-efficient medication access for WellDyne’s Clients. The Formulary Manager reports directly to the Director, Clinical Pharmacy Operations and collaborates with cross-functional teams to achieve organizational objectives. Essential Duties and Responsibilities * Create and maintain drug lists, including tier placement, formulary changes and utilization management changes * Evaluate new and existing drugs for safety, efficacy and cost-effectiveness to inform coverage decisions * Develop and manage prior authorization (PA) criteria, step therapy rules and quantity limits * Support clinical aspects of implementation for new Clients, plans, plan changes and other clinical plan set-up requirements * Prepare and present at Pharmacy & Therapeutics (P&T) committee meetings to make formulary decisions * Analyze pharmacy claims data to identify cost-saving opportunities and trends in drug utilization * Collaborate with cross-functional decision-making teams regarding favorable formulary positioning based on manufacturer rebates and discounts * Ensure compliance with state/federal regulations * Performs additional duties as assigned Education and Experience * PharmD or Registered Pharmacist (RPh) license * Previous experience in managed care, PBM Operations, or clinical pharmacy Knowledge, Skills and Abilities * Proficiency in MS Excel, data analysis tools, and claims management software * Strong understanding of drug therapy, pharmacology, and pharmacy benefits structures * Ability to communicate complex clinical and financial data to diverse stakeholders Work Environment / Physical Demands This position is in a typical office environment which requires prolonged sitting in front of a computer. Requires hand-eye coordination and manual dexterity sufficient to operate standard office equipment including operation of standard computer and phone equipment. May have occasional high stress when dealing with customers/clients. Some travel may be required. EOE M/F/D/V – WellDyne and HealthDyne are equal opportunity employer and prohibits discrimination of any kind. All employment decisions are based on business needs, job requirements, and individual qualifications, without regard to race, color, religion, gender, sexual orientation, gender identity, national origin, veteran or disability status, or any other protected status under federal, state, or local law.

Responsibilities

The Formulary Manager designs and maintains prescription drug lists to balance clinical efficacy with cost-effectiveness. They also manage utilization management rules and analyze pharmacy claims data to identify cost-saving opportunities.