JOB SUMMARY
This senior pharmacist role requires the incumbent to balance clinical and business acumen to implement and provide ongoing support and oversight of assigned pharmacy programs. This pharmacist will work in a team-oriented environment as a subject matter expert of assigned pharmacy program offerings with both clinical and non-clinical focus. The incumbent is responsible for implementation, market introduction, overall performance, and continuous improvement of their assigned programs. The incumbent will work with internal partners and leadership to develop a firm grasp of the organization's clinical program strategy as it evolves over time to enhance the value that is delivered to the organization's customers.
ESSENTIAL RESPONSIBILITIES
Subject Matter Expertise & Program Leadership: Act as the subject matter expert (SME) for assigned programs and related workflows, including those with high complexity. Function independently as business SME during assigned program implementations, expansions, and enhancements. Meet or exceed assigned program goals and objectives. Provide formal or informal leadership to support pharmacy strategy initiatives.
Program Monitoring & Evaluation: Monitor outcomes of operational and technical enhancements to assigned programs. Monitor, evaluate and present pharmacy data related to assigned programs; make recommendations for data analysis and reporting to monitor effectiveness and value.
Compliance & Documentation: Ensure ongoing state and federal compliance of assigned programs, in concert with legal, product, and risk matrix partners. Development and maintenance of internal program documentation, coordinating between matrix teams where appropriate.
Stakeholder Education & Communication: Development and maintenance of accurate marketing materials for assigned programs. Provide written and verbal education on assigned programs to internal stakeholders.
Program Optimization & Efficiency: Identify and support opportunities for program efficiencies and/or enhancements.
Interdepartmental Collaboration: Ensure compatibility with medical product solutions where applicable. Work effectively within a matrixed environment to assemble and facilitate project and ad-hoc teams to reach determined objectives.
Other duties as assigned or requested.
EXPERIENCE
Required
5 years of related, progressive experience in the pharmacy area of specialization OR completion of an accredited PGY-1 Managed Care Pharmacy Residency Program plus 2 additional years of related, progressive experience in the pharmacy area of specialization
Preferred
Progressive experience in pharmacy strategy, formulary administration, pharmacy program or product development within a health system, health plan, or pharmacy benefit manager setting
SKILLS
An understanding of managed care pharmacy principles and practices is essential
Demonstration of strong verbal and written communication skills, as well as proficiency in the use of computer-based data processing
Microsoft Office products, and database applications
Be able to quickly identify and prioritize essential elements of problem
Independently or in a team, be able to identify the root issues and formulate potential solutions
An understanding of managed care principles and practices is essential
EDUCATION
Required
Bachelor of Science in Pharmacy or a Doctor of Pharmacy degree
Preferred
None
LICENSES or CERTIFICATIONS
Required
Registered Pharmacist (Non-State Specific)
Preferred
None
Language (Other than English):
None
Travel Required:
Less than 25%
PHYSICAL, MENTAL DEMANDS and WORKING CONDITIONS
Position Type
Office-Based or Remote Position
Physical work site required
Frequently
Disclaimer: The job description has been designed to indicate the general nature and essential duties and responsibilities of work performed by employees within this job title. It may not contain a comprehensive inventory of all duties, responsibilities, and qualifications required of employees to do this job.
Compliance Requirement: This job adheres to the ethical and legal standards and behavioral expectations as set forth in the code of business conduct and company policies.
As a component of job responsibilities, employees may have access to covered information, cardholder data, or other confidential customer information that must be protected at all times. In connection with this, all employees must comply with both the Health Insurance Portability Accountability Act of 1996 (HIPAA) as described in the Notice of Privacy Practices and Privacy Policies and Procedures as well as all data security guidelines established within the Company’s Handbook of Privacy Policies and Practices and Information Security Policy.
Furthermore, it is every employee’s responsibility to comply with the company’s Code of Business Conduct. This includes but is not limited to adherence to applicable federal and state laws, rules, and regulations as well as company policies and training requirements.
Pay Range Minimum:
$118,400.00Pay Range Maximum:
$196,800.00Base pay is determined by a variety of factors including a candidate’s qualifications, experience, and expected contributions, as well as internal peer equity, market, and business considerations. The displayed salary range does not reflect any geographic differential Highmark may apply for certain locations based upon comparative markets.
Highmark Health and its affiliates prohibit discrimination against qualified individuals based on their status as protected veterans or individuals with disabilities and prohibit discrimination against all individuals based on any category protected by applicable federal, state, or local law.
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For accommodation requests, please contact HR Services Online at [email protected]
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Skills Required
- 5 years of related, progressive experience in the pharmacy area of specialization OR completion of an accredited PGY-1 Managed Care Pharmacy Residency plus 2 additional years
- Understanding of managed care pharmacy principles and practices
- Strong verbal and written communication skills
- Proficiency in computer-based data processing
- Microsoft Office products and database applications
- Ability to identify and prioritize problems, perform root cause analysis, and formulate solutions independently or in a team
- Bachelor of Science in Pharmacy or Doctor of Pharmacy (PharmD) degree
- Registered Pharmacist (Non-State Specific)
- Progressive experience in pharmacy strategy, formulary administration, pharmacy program or product development within a health system, health plan, or PBM
Highmark Health Compensation & Benefits Highlights
The following summarizes recurring compensation and benefits themes identified from responses generated by popular LLMs to common candidate questions about Highmark Health and has not been reviewed or approved by Highmark Health.
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Healthcare Strength — Medical, prescription, dental, and vision coverage are emphasized alongside 100% coverage for preventive exams, with onsite pharmacy access and fitness center availability at major campuses.
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Retirement Support — An employer‑sponsored 401(k) with a company match is highlighted, with AHN materials illustrating a 100% match on the first 4% plus an additional 1% employer contribution as an example within the enterprise.
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Wellbeing & Lifestyle Benefits — Wellness programs include stress‑management classes, health coaching, incentives for healthy activities, team‑member discounts, and volunteer incentives, with paid volunteer time also noted in the overall package.
Highmark Health Insights
What We Do
Highmark Health, a Pittsburgh, PA based enterprise that employs more than 40,000 people who serve millions of Americans across the country, is the second largest integrated health care delivery and financing network in the nation based on revenue. Highmark Health is the parent company of Highmark Inc., Allegheny Health Network, and HM Health Solutions. Highmark Inc. and its subsidiaries and affiliates provide health insurance to nearly 5 million members in Pennsylvania, West Virginia and Delaware as well as dental insurance, vision care and related health products through a national network of diversified businesses that include United Concordia Companies, HM Insurance Group, and Visionworks. Allegheny Health Network is the parent company of an integrated delivery network that includes eight hospitals, more than 2,800 affiliated physicians, ambulatory surgery centers, an employed physician organization, home and community-based health services, a research institute, a group purchasing organization, and health and wellness pavilions in western Pennsylvania. HM Health Solutions focuses on meeting the information technology platform and other business needs of the Highmark Health enterprise as well as unaffiliated health insurance plans by providing proven business processes, expert knowledge and integrated cloud-based platforms. A national blended health organization, Highmark Health and our leading businesses support millions of customers with products, services and solutions closely aligned to our mission of creating remarkable health experiences, freeing people to be their best. Headquartered in Pittsburgh, we're regionally focused in Pennsylvania, Delaware, West Virginia and New York, with customers in all 50 states and the District of Columbia. We passionately serve individual consumers and fellow businesses alike. Our companies cover a diversified spectrum of essential health-related needs, including health insurance, health care delivery, population health management, dental solutions, reinsurance solutions, and innovative technology solutions. We’re also proud to carry forth an important legacy of compassionate care and philanthropy that began more than 170 years ago. This tradition of giving back, reinvesting and ensuring that our communities remain strong and healthy is deeply embedded in our culture, informing our decisions every day.
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