Preferred Drug List Pharmacist

Gainwell Technologies

. Support the clinical, operational, and financial Preferred Drug List needs of the Delaware Medicaid Fee-for-Service line of business .

Posted 11/5/2026full-timeRemote • Michigan • United StatesMid-LevelSenior💰 $113,700 - $162,400 per yearWebsite

Core Competencies

Role fit

Core Competencies

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Demonstrates expertise in pharmacy benefits management, Medicaid regulations, and formulary management while effectively analyzing clinical evidence and market dynamics to drive strategic drug coverage recommendations. Strong communication and relationship-building skills are essential for collaboration with stakeholders and presenting actionable insights.

Highest-signal resume keywords

Registered Pharmacist LicensePharmD or Equivalent EducationPharmacy Benefits Management ExperienceMedicaid KnowledgeAnalytical Skills

ATS Keywords

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Applicant Tracking System Keywords

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Hard Skills

Formulary ManagementClinical Evidence AnalysisPrior Authorization Criteria DevelopmentDrug CodingUtilization ManagementMarket Share AnalysisCost AnalysisTherapeutic Class ReviewsPharmacy & Therapeutics Committee SupportDrug Utilization Review Board Activities

Soft Skills

Client Relationship SkillsCommunication SkillsConfidentiality MaintenanceCollaboration SkillsProblem-Solving Skills

Tools & Technologies

Healthcare TechnologyPharmacy Analytics

Certifications & Qualifications

Active Registered Pharmacist License

Industry Keywords

MedicaidDrug Rebate ProgramValue-Based AgreementsVolume-Based AgreementsBiosimilarsGenericsDrug Market ChangesPharmacy OperationsGainwell PoliciesEastern Time Zone

About the role

Key responsibilities & impact

Support the clinical, operational, and financial Preferred Drug List needs of the Delaware Medicaid Fee-for-Service line of business
Oversee development, implementation, maintenance, and expansion of a clinically appropriate and fiscally responsible PDL
Ensure adjudication and related communications reflect current program requirements
Monitor drug market changes, launches, generics, biosimilars, discontinuations, pricing, shortages, patent expirations, and Medicaid Drug Rebate Program changes
Develop and maintain prior authorization criteria, drug coding and status files, therapeutic class reviews, publications, and Pharmacy & Therapeutics Committee materials
Analyze clinical evidence, utilization, market share, net cost, and rebate considerations
Develop strategic recommendations for drug coverage, therapeutic classes, and utilization management
Serve as primary Delaware contact and subject matter expert for PDL maintenance, development, expansion, and transformation
Present clinical and financial recommendations to clients and Pharmacy & Therapeutics Committee stakeholders
Coordinate across clinical, account, pharmacy, and other internal and external teams
Drive continuous improvement of PDL operations and financial programs, including value-based and volume-based agreements, Brand over Generic, and preferred diabetic supply programs
Support the Gainwell Pharmacy Center of Excellence

Requirements

What you’ll need

Active, unrestricted Registered Pharmacist license in any state
PharmD or equivalent education and experience
At least three years of pharmacy benefits management or managed care experience
Knowledge of Medicaid at the state and/or federal level
Experience working in Medicaid, healthcare technology, and/or pharmacy analytics
Experience supporting Pharmacy & Therapeutics Committee and Drug Utilization Review Board activities
Experience managing formularies from clinical, operational, and financial perspectives
Strong analytical, client relationship, communication, and technology skills
Ability to translate complex clinical and business information into actionable recommendations
Ability to work Eastern Time Zone hours
Maintain confidentiality and comply with HIPAA and applicable Gainwell policies
Maintain regular attendance and effective working relationships with coworkers, clients, members, providers, and customers

Benefits

Comp & perks

Flexible hours
Work-life balance
Continuous learning and career development
Generous, flexible vacation policy
401(k) employer match
Comprehensive health benefits
Educational assistance
Leadership and technical development academies
Work flexibility