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Gateway Health Partners · 13 hours ago

Manager, Formulary & Clinical Programs Operations

United States

Full-time

Remote

Senior Level, Lead/Staff

8+ years exp

Gateway Health Partners is the largest independent provider of rebates and formulary management services in the United States. The Manager, Formulary & Clinical Program Operations is responsible for managing formulary operations and ensuring timely delivery of services to clients, while also overseeing communication and compliance related to clinical programs.

Health CareHospitalPharmaceutical

Hiring Manager

Molly McPeak

Responsibilities

Maintain and manage all standard formularies and ensure timely delivery to clients

Manage communication and interactions with clients regarding updates/changes

Manage and update formularies and preferred drug lists (PDLs)

Collect and upload clients’ custom formularies and PDLs to ensure they are correctly uploaded into the system and that tier definitions are clearly understood and documented

Support internal team members respond to formulary and utilization management questions

Collect clients’ utilization management criteria and review as needed to ensure compliance to rebate contract terms

Monitor formulary compliance for clients to ensure it is within expected parameters; and to internally escalate any concerns if an issue has been identified

Monitor new drug releases and launches to proactively identify potential issues and work with internal/external stakeholders to take corrective action

Manage and maintain all clinical marketing documents to ensure completeness and accuracy

Assist other members of the clinical team with special projects as needed

Help support P&T and other internal/external meetings

Monitor the marketplace for market intelligence that impacts the organization or its clients

Foster process improvements and build/update policies and procedures

Manage, improve and establish clinical reporting and automation as required by client and business needs

Serve as clinical support and a clinical liaison to other internal departments

Serve as a drug information resource for the clinical team as well as internal and external clients

Serve as backup support for other clinical team members

Additional tasks as the business need arises to help the clinical team and enterprise

Promptly report any allegations of impropriety to the Compliance Department

Comply with GHP’s Ethical Business Conduct policy and GHP’s Compliance Program

Remain free from exclusion under the OIG and SAMS Medicare/Medicaid lists

Complete required training, as assigned, within the established timeframes

Qualification

Pharmacy DegreePharmacist LicensurePBM Clinical ExperienceFormulary DevelopmentClinical Trials KnowledgeMicrosoft Office ProficiencyAnalytical SkillsCustomer ServiceLeadership SkillsCommunication Skills

Required

Bachelor or Doctorate Degree Pharmacy from an accredited school of pharmacy

Current Pharmacist licensure in good standing, in at least one state

8 years' experience in PBM clinical role or related field

Preferred

Completed Managed Care Residency Program

Benefits

Highly competitive compensation package

Comprehensive mental health and wellbeing resources

Nationwide Blue Cross Blue Shield PPO with employee friendly plan design, including $850 individual annual medical deductible, $25 office visit copays, Low biweekly premiums

Company paid basic life/AD&D, Short-term and Long-term disability insurance

Rx, dental, vision, voluntary benefit options, and FSA

Employer-matched 401k Plan

Industry leading PTO plan

And more!