Associate Director, Formulary Operations Management
Core
Lead the development, implementation, maintenance, and governance of pharmacy formularies and utilization management strategies across lines of business.
Role type
Senior leadership IC in formulary operations and utilization management
Builds
Pharmacy formulary strategies, utilization management programs, and operational workflows
Domain
Healthcare / Pharmacy Benefit Management (PBM) / Managed Care
Required skills
Formulary management, Utilization management, Regulatory compliance, Cross-functional leadership, Data analysis, Project management, Policy development, Team leadership
Preferred skills
Medicaid/Medicare/Commercial formulary experience, Data analytics tools (SQL, Power BI, Tableau), Large-scale implementation leadership, Master's in Healthcare Administration
Technologies
SQL, Power BI, Tableau, Microsoft Excel, Microsoft PowerPoint, Microsoft Word, Microsoft Teams
Responsibilities
Lead formulary development and maintenance; Oversee operational implementation of formulary changes; Support utilization management programs (prior authorization, step therapy); Evaluate formulary performance via data analysis; Ensure compliance with state/federal requirements; Develop policies and procedures; Partner on regulatory submissions and audits; Lead strategic projects for operational excellence; Lead and develop a high-performing team
Seniority
Senior, hands-on IC with people leadership