Principal Medicaid Pharmacy Strategist, PDL, Pricing & Contracting
New
G
Gainwell TechnologiesMedicaid pharmacy
100% Remote (U.S. only)Full-TimePrincipal
Salary113,700 - 162,400 USD per year
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Job Details
- Experience
- 5+ years of pharmacy experience
- Required Skills
- Microsoft Excel
Requirements
- Be a licensed Pharmacist (RPh or PharmD) in the U.S.
- Have 5+ years of pharmacy experience, including Medicaid pharmacy, managed care, PBM operations, formulary management, or related areas.
- Know Medicaid pharmacy programs, including PDLs, utilization management, prior authorization, claims adjudication, and pharmacy benefit operations.
- Have experience with drug pricing, Medicaid rebates, supplemental rebates, pharmaceutical contracting, and financial analysis.
- Have experience developing or evaluating formularies, PDLs, prior authorization, and utilization management criteria.
- Demonstrate advanced Microsoft Excel skills, including analysis of large datasets and financial modeling.
- Translate clinical, pricing, utilization, and rebate data into pharmacy benefit recommendations.
- Use analytical and problem-solving skills to identify and reconcile data discrepancies across multiple sources.
- Preferred: Experience supporting state Medicaid PDL programs, Medicaid supplemental rebate programs, rebate pools, or multi-state contracting initiatives.
Responsibilities
- Support Medicaid Preferred Drug List (PDL) strategy by analyzing 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.
- 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 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 analytical documentation.
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