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Clinical Formulary Pharmacist

None • FL, US • published 2026-11-06 06:59:13.137868

Description

**Position Purpose:** Define and develop standard and custom formularies for all lines of business including Commercial, Medicaid, Medicare Part D and the Health Information Marketplace **Key Details:** This is a fully remote position. Candidates located in the **CST or EST time zones are preferred**. During the first 6 months, the selected candidate must be available for training and work hours that provide at least 75% overlap with the team’s **8:00 AM–4:30 PM PST** schedule. * Develop drug product review and formulary recommendations by assessing drug use trends, new drug releases and review of primary literature • Analyze pharmacy cost of care, trends, and coordinate the development of appropriate use protocols and guidelines • Set criteria for medication analysis, coordinate reports to clients, meet regulatory reporting requirements for drug utilization review and fraud and abuse reporting • Develop clinical criteria for review of non\-formulary or non\-preferred drug lists medications and communicate recommendations to clients • Develop and design clinical edits to adjudicate claims and enhance drug utilization • Develop and review guideline criteria for prior authorization a...

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