[Hiring] Senior Manager, Pharmacy @Gravie

Role Description

We’re seeking a strategic, hands-on pharmacy leader to own clinical oversight of our PBM and pharmacy vendors, drive formulary and UM strategy, and provide clinical expertise to shape our pharmacy affordability programs. This role bridges clinical expertise and operational execution to drive sustainable pharmacy spend and strong member outcomes.

• Serve as the primary pharmacy clinical lead for our PBM partnership, including oversight of utilization management, formulary and clinical programs
• Design, implement and manage clinical programs that drive affordability, quality, and member outcomes
• Provide clinical oversight of pharmacy vendors and clinical programs that improve outcomes and reduce unnecessary utilization
• Own formulary design and maintenance, including tier strategy, drug placement, therapeutic class management, and clinical edit logic
• Complete reviews of prior authorization decisions and appeals for specialty and non-specialty drugs
• Develop and maintain policies related to clinical pharmacy and both pharmacy and medical benefit drugs
• Collaborate with actuarial, finance, and product teams to inform pricing, trend modeling, pharmacy spend forecasting, and stop-loss considerations
• Partner cross-functionally with product, clinical, network, actuarial and other stakeholders to ensure integrated care approaches
• Ensure compliance with applicable regulatory, accreditation, and clinical governance standards, maintaining high ethical and quality standards

Qualifications

• PharmD degree and active, unrestricted pharmacist license required
• 5+ years of pharmacy experience in clinical operations, utilization management, or formulary leadership
• Demonstrated experience in contracting oversight or performance evaluation with PBMs or pharmacy vendors
• (Bonus) Experience working within commercial level-funded health plans and/or innovative health insurers (e.g., startup or growth-stage plans)

Benefits

• Alternative medicine coverage
• Flexible PTO
• Up to 16 weeks paid parental leave
• Paid holidays
• 401k program
• Transportation perks
• Education reimbursement
• 2 days of paid paw-ternity leave