[Hiring] Principal Medicaid Pharmacy Strategist @Gainwell Technologies LLC

Role Description

As a Principal Medicaid Pharmacy Strategist, PDL, Pricing & Contracting at Gainwell, you will contribute your pharmacy, Medicaid, analytical, and clinical expertise to support state Medicaid pharmacy programs and the populations they serve. This role supports the development and maintenance of Medicaid Preferred Drug Lists (PDLs), clinical coverage criteria, drug cost analyses, and supplemental rebate strategies.

• Support Medicaid Preferred Drug List (PDL) strategy through analysis of drug products, clinical criteria, utilization, pricing, and rebate opportunities.
• Conduct financial analyses using drug pricing, utilization, and Medicaid rebate data to support formulary and coverage recommendations.
• Evaluate clinical criteria, prior authorizations, and pharmacy benefit requirements to optimize access, cost, and rebate outcomes.
• Analyze utilization, expenditures, pricing trends, and supplemental rebate offers to develop client recommendations.
• Build reports, forecasts, and analytical models using advanced Excel and large datasets.
• Present findings to clients and committees, translating complex clinical and financial data into actionable recommendations.
• Collaborate with cross-functional teams to implement PDL, rebate, and pharmacy program strategies.
• Monitor market developments, validate program data, and maintain accurate analytical documentation.

Qualifications

• Licensed Pharmacist (RPh or PharmD) in the U.S.
• 5+ years of pharmacy experience, including Medicaid pharmacy, managed care, PBM operations, formulary management, or related areas.
• Strong knowledge of Medicaid pharmacy programs, including PDLs, utilization management, prior authorization, claims adjudication, and pharmacy benefit operations.
• Experience with drug pricing, Medicaid rebates, supplemental rebates, pharmaceutical contracting, and financial analysis.
• Experience developing or evaluating formularies, PDLs, prior authorization, and utilization management criteria.
• Advanced Microsoft Excel skills, including analysis of large datasets and financial modeling.
• Ability to translate clinical, pricing, utilization, and rebate data into sound pharmacy benefit recommendations.
• Preferred: Experience supporting state Medicaid PDL programs, Medicaid supplemental rebate programs, rebate pools, or multi-state contracting initiatives.
• Strong analytical and problem-solving skills with experience identifying and reconciling data discrepancies across multiple sources.

Requirements

• 100% Remote (U.S. only)
• Travel: Up to 10%
• Applications will be accepted through November 13, 2026.
• The pay range for this position is $113,700.00 - $162,400.00 per year, however, the base pay offered may vary depending on geographic region, internal equity, job-related knowledge, skills, and experience among other factors.

Benefits

• Generous, flexible vacation policy
• 401(k) employer match
• Comprehensive health benefits
• Educational assistance
• Leadership and technical development academies to help build your skills and capabilities.