Formulary Operations Pharmacist - Medicare

The Phoenix Health Search Group
New York, NY
  • Description:
    One of the PBM Industry’s fastest-growing players is seeking a strategic PharmD Formulary Operations Pharmacist-Medicare professional responsible for providing operational support for the evaluation, implementation, and maintenance of Medicare Part D formularies and utilization management. This role will be instrumental in supporting sales efforts and improving formulary disruption processes and workflows.


    Some of the position responsibilities include:

    Maintain standard and custom formularies for the Medicare line of business in accordance with CMS Medicare guidelines

    Support development, implementation, maintenance, and quality control of Medicare Part D formularies, utilization management, and clinical adjudication drug lists

    Identify opportunities for expansion of the low-cost alternative program, aiming to reduce overall drug spend without compromising care.

    Analyze and interpret prescription claims data to identify trends, potential risks, and opportunities for improvement in formulary strategy.

    Support Pharmacy and Therapeutics (P&T) committee items, as required.

    The compensation plan includes a salary, ranging from $125,000- $135,000 (do/e), plus bonus, equity, and benefits.

    Preferably, this position will be filled in either the New York City OR Denver Metro areas, but it can also be filled remotely.

  • Requirements:
    The ideal candidate for this position must be a PharmD from an accredited institution, with record of strong academic performance.

    Current, unrestricted registered pharmacist license(s)

    Residency/fellowship preferred

    Minimum 2+ years of pharmacy experience working for a health plan or PBM

    2-3 years of Medicare experience preferred

    Understanding of formulary management, claims data analysis, and drug utilization strategies

    Experience working with large datasets required

    Proficient in Microsoft Office with strong emphasis on Microsoft Excel and Microsoft PowerPoint

    Ability to balance multiple complex projects simultaneously

    Extremely flexible, highly organized, and able to shift priorities easily

    Attention to detail & commitment to delivering high quality work product

    Qualified candidates should send their resumes in MS Word format to: mail@

Posted 2025-11-27

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