Pharmacy Director Formulary & Utilization Management

Newport News, Virginia

Hiring Range

$168,300.00 - $244,050.00/Annual Actual pay is determined based on job-related factors such as relevant experience, education, credentials, skills, internal equity, and business needs.
Overview
The Director of Pharmacy Formulary & Utilization Management will provide enterprise leadership and strategic oversight for the health system's medication formulary, formulary management system and pharmacy utilization management programs. This position will direct systemwide formulary governance, therapeutic standardization, biosimilar adoption, drug-use optimization, and cost-management strategies in both inpatient and outpatient settings to ensure safe, evidence-based, and fiscally responsible medication use across the integrated delivery network. The Director will partner closely with pharmacy leadership, supply chain, analytics, medical staff, and service lines to drive consistency, financial stewardship, and high-quality medication management.
What you will do

• Provides enterprise leadership of the system formulary and formulary management system, directing governance processes, evidence review standards, approval pathways, and systemwide implementation, while co-chairing the P&T Committee to ensure alignment with quality, clinical, and operational priorities
• Leads systemwide utilization management strategies, including development of drug-use criteria, therapeutic substitutions, and step-therapy protocols designed to optimize clinical appropriateness and reduce unwarranted variation
• Oversees high-cost therapeutic management, guiding therapeutic class reviews, formulary monograph development, evidence evaluations, and interdisciplinary collaboration to improve access, care coordination, and value for complex and specialty therapies
• Directs product and medication-use optimization initiatives, ensuring enterprise standardization of medication products, concentrations, and therapeutic interchange programs to enhance safety, efficiency, and consistency across the organization
• Provides pharmacoeconomic leadership, conducting budget impact assessments, ROI analyses, and total-cost-of-care modeling to support formulary decisions and strategic planning for high-cost and emerging therapies
• Identifies and leads systemwide financial management initiatives aimed at reducing drug spend, improving therapeutic value, minimizing waste, and enhancing the financial performance of the pharmacy enterprise in collaboration with finance, reimbursement, and payer strategy teams
• Monitors enterprise medication utilization and financial trends, leveraging analytics and benchmarking to identify opportunities, anticipate market shifts, evaluate medication mix, and deliver executive-level reporting on key indicators.
• Oversees formulary-related EMR integration and clinical decision support, ensuring medication builds, order sets, and CDS tools support safe prescribing, formulary compliance, high-cost drug management, and utilization management policies
• Provides leadership, collaboration, and team oversight, fostering strong relationships with clinicians and operational partners, ensuring clear communication of formulary decisions and medication-use policies, and cultivating a culture of accountability, continuous improvement, and alignment with system priorities.

Qualifications
Education

• Bachelors Degree, or higher in Pharmacy (Required)

Experience

• 3 years Clinical Pharmacy experience (Required)
• 2 years Leadership or Supervisory experience (Required)
• 1 year PGY-1 Residency (Required)
• 1 year PGY-2 Residency (Preferred)

Skills and Abilities

• Knowledge of formulary governance and evidence-based drug evaluation, including class reviews and monograph development
• Understanding of utilization management strategies, such as drug-use criteria, therapeutic substitutions, and step therapy
• Knowledge of Pharmacoeconomics and financial modeling, including budget impact, ROI, and total-cost-of-care analyses
• Skill in medication and product standardization, including biosimilar adoption and therapeutic interchange
• Ability to analyze utilization and financial data, using trends and benchmarks to guide decisions
• Knowledge of EMR formulary integration and clinical decision support, including medication builds and order set alignment
• Ability to lead cross-functional collaboration with clinicians, pharmacy leaders, supply chain, finance, and analytics
• Skill in developing and communicating formulary policies and medication-use guidelines
• Ability to drive performance and manage change across diverse care settings
• Strong leadership and influence skills with the ability to guide governance processes and engage stakeholders

Licenses and Certifications

• Licensed Pharmacist - Virginia Department of Health Professions (VDHP) within 60 Days(Required)
• Board of Pharmacy Specialties (BPS) - Board of Pharmacy Specialties within 2 Years(Required)

To learn more about being a team member with Riverside Health System visit us at https://www.riversideonline.com/careers.