Clinical Formulary Pharmacist

Centene Corporation

Clinical Formulary Pharmacist developing standard and custom formularies for managed care organizations. Analyzing drug trends, developing clinical criteria, and providing guidance to pharmacy technicians.

Posted 6/17/2026full-timeRemote • Arizona, California • 🇺🇸 United StatesMid-LevelSenior💰 $107,700 - $199,300 per yearWebsite

About the role

Key responsibilities & impact

Define and develop standard and custom formularies for all lines of business including Commercial, Medicaid, Medicare Part D and the Health Information Marketplace
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 and non-formulary drugs in support of Pharmacy and Therapeutics Committee function and pharmacy benefit design
Research drug information to maintain drug knowledge and disease state understanding for application to prior authorization reviews
Provide clinical guidance and support to the assigned pharmacy technicians
Provide support documentation and develop communication for the Pharmacy & Therapeutic (P&T) Committee review process and decisions
Performs other duties as assigned

Requirements

What you’ll need

Bachelor’s degree or advanced degree (PharmD., M.S) in pharmacy
3+ years of combined managed care pharmacy or pharmacy residency program experience
Current state’s Pharmacist license with no restrictions

Benefits

Comp & perks

competitive pay
health insurance
401K and stock purchase plans
tuition reimbursement
paid time off plus holidays
flexible approach to work with remote, hybrid, field or office work schedules

ATS Keywords

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Applicant Tracking System Keywords

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Hard Skills & Tools

formulary developmentdrug product reviewpharmacy cost analysismedication analysisclinical criteria developmentdrug utilization reviewprior authorization guidelinesclinical edits designdrug information researchcommunication documentation

Soft Skills

clinical guidancecoordinationanalytical skillscommunication skillsclient interactionteam supportproblem-solvingattention to detailorganizational skillsleadership

Certifications

Pharmacist license