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Manager Formulary Management Jobs (NOW HIRING)

Elevance Health

Director Clinical Affairs - Medicaid

Mason, OH · Hybrid

$75.20K - $102.50K/yr

This role provides leadership and oversight for Medicaid formulary management, ensuring alignment with state-specific regulatory requirements, clinical policies, and cost-of-care strategies while ...

FOCUSPOINT

Clinical Pharmacy Manager

Nashville, TN · On-site

$169K/yr

This includes formulary management, policy and procedure development and education across the healthcare spectrum. The Clinical Manager shall also assist in managing the pharmacy when the Pharmacy ...

Elevance Health

Director Clinical Affairs - Medicaid

Mason, OH · Hybrid

$75.20K - $102.50K/yr

This role provides leadership and oversight for Medicaid formulary management, ensuring alignment with state-specific regulatory requirements, clinical policies, and cost-of-care strategies while ...

Partner with PPHP

Pharmacy Business Analyst

Formulary Management : * Assist in the evaluation and optimization of the drug formulary to ensure cost-effective medication options are available to members. * Monitor drug utilization and perform ...

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How much do manager formulary management jobs pay per year?

As of May 31, 2026, the average yearly pay for manager formulary management in the United States is $141,960.00, according to ZipRecruiter salary data. Most workers in this role earn between $127,000.00 and $149,500.00 per year, depending on experience, location, and employer.

What are the key skills and qualifications needed to thrive as a Manager Formulary Management, and why are they important?

To excel as a Manager Formulary Management, you need a strong background in pharmacy, clinical therapeutics, and formulary design, usually supported by a PharmD or advanced pharmacy degree and relevant experience. Familiarity with pharmacy benefit management (PBM) systems, drug utilization review tools, and data analytics platforms is essential. Strong leadership, communication, and analytical skills enable effective collaboration with cross-functional teams and informed decision-making. These competencies ensure optimal formulary strategies that balance clinical efficacy, cost-effectiveness, and regulatory compliance.

What are some common challenges faced by a Manager of Formulary Management, and how can they be addressed?

Managers of Formulary Management frequently encounter challenges such as balancing cost containment with ensuring access to clinically effective medications, staying current with evolving drug therapies, and managing complex stakeholder relationships. To address these, it is important to implement evidence-based evaluation processes, foster open communication with pharmacy and medical teams, and engage in ongoing professional development to keep up with regulatory and industry changes. Collaborating closely with data analysts, clinicians, and external vendors also helps ensure timely, informed formulary decisions that meet both organizational and patient needs.

What is a Manager of Formulary Management?

A Manager of Formulary Management is a professional responsible for overseeing the selection, evaluation, and ongoing management of prescription drug formularies within healthcare organizations, such as health plans or pharmacy benefit managers. They ensure that the formulary is clinically appropriate, cost-effective, and meets the needs of patients and providers. Their role involves collaborating with pharmacists, physicians, and other stakeholders to develop policies, review medication usage, and implement strategies to optimize drug therapy. They also monitor regulatory compliance and analyze drug trends to make evidence-based recommendations.

What is the difference between Manager Formulary Management vs Pharmacist?

AspectManager Formulary ManagementPharmacist
CredentialsTypically requires a bachelor's degree in health administration or related field; certifications in formulary management are a plusRequires a Doctor of Pharmacy (Pharm.D.) degree and licensure
Work EnvironmentHealthcare organizations, insurance companies, or pharmacy benefit managersCommunity pharmacies, hospitals, or clinics
Industry UsageUsed in healthcare administration and formulary decision-makingDirect patient care and medication dispensing

Manager Formulary Management focuses on overseeing medication formularies and policy development within healthcare organizations, while Pharmacists are involved in dispensing medications and patient counseling. Both roles require healthcare knowledge but differ in responsibilities and work settings.

More about Manager Formulary Management jobs
What cities are hiring for Manager Formulary Management jobs? Cities with the most Manager Formulary Management job openings:
What are the most commonly searched types of Formulary Management jobs? The most popular types of Formulary Management jobs are:
What states have the most Manager Formulary Management jobs? States with the most job openings for Manager Formulary Management jobs include:
What job categories do people searching Manager Formulary Management jobs look for? The top searched job categories for Manager Formulary Management jobs are:
Manager Formulary Management jobs near you
Infographic showing various Manager Formulary Management job openings in the United States as of May 2026, with employment types broken down into 84% Full Time, and 16% Part Time. Highlights an 100% Physical job distribution, with an average salary of $141,960 per year, or $68.2 per hour.
Pharmacist, Prior Auth/Utilization Management, Remote

Pharmacist, Prior Auth/Utilization Management, Remote

Molina Healthcare

Fort Lauderdale, FL • Remote

$80.41K - $156.80K/yr

Full-time

Posted 8 days ago

Molina Healthcare rating

8.0

Company rating: 8.0 out of 10

Based on 191 frontline employees who took The Breakroom Quiz

145th of 259 rated insurance

Job description

Molina Healthcare is hiring for a Pharmacist in our UM/Prior Authorization department. This position is remote and can be worked from a variety of locations within the US.

Shift times can be either 8 or 10 hour shifts between the times of 7a and 10p EST with rotating weekends depending on business needs.

Molina Pharmacy Services/Management staff work to ensure that Molina members have access to all medically necessary prescription drugs and those drugs are used in a cost-effective, safe manner. These jobs are responsible for creating, operating, and monitoring Molina Health Plan's pharmacy benefit programs in accordance with all federal and state laws. Jobs in this family include those involved in formulary management (such as, reviewing prior authorization requirements, reviewing drug/provider utilization patterns and pharmacy costs management), clinical pharmacy services (such as, therapeutic drug monitoring, drug regimen review, patient education, and medical staff interaction), and oversight (establishing and measuring performance metrics regarding patient outcomes, medications safety and medication use policies).

KNOWLEDGE/SKILLS/ABILITIES

The Pharmacist, UM will be responsible for reviewing coverage determinations and appeals in a timely, compliant, and accurate manner. The Pharmacist, UM will also be responsible for serving as a formulary and drug information resource, assisting technicians and other departments with questions regarding drug coverage.

  • Acts as a liaison between Molina and its customers (members, providers and pharmacies) with respect to the pharmacy benefit. 
  • Serves as the formulary expert.
  • Ensures Molina is compliant with the coverage determination and appeals process.
  • Contributes to projects aimed at improving Star ratings, HEDIS, CAHPS, and other quality metrics.
  • Assists call center pharmacy technicians with clinical questions and phone calls from prescribers, pharmacies and/or members.
  • Develops, implements and maintains pharmacy cost control and quality initiatives under the direction of leadership.
  • Monitors drug utilization and assists leadership team in understanding quality and cost control issues related to pharmacy.
  • Works in tandem with Molina Medical Directors to ensure accurate coverage determination decisions.
  • Works with leadership on developing annual training sessions for applicable staff regarding the pharmacy benefit changes for the upcoming year.
  • Works with the Case Management department as part of a member-centered interdisciplinary care team.
  • Works with the PBM to manage formulary changes and update marketing on any changes needed on the web or print versions of the formulary.
  • Performs outreach to patients and physicians as part of quality and/or cost control initiatives.
  • Provides leadership for the pharmacy call center team as delegated by the Manager.
  • Identifies and implements programs to improve clinical outcomes stemming from medication selection, utilization, and adherence.

JOB QUALIFICATIONS

Required Education

  • Doctor of Pharmacy or bachelor’s degree in pharmacy with equivalent experience.
  • Continuing education required to maintain an active pharmacist license.                                                                                                

Required Experience: 1 - 2 years post-graduate experience.

Required License, Certification, Association: Active and unrestricted State Pharmacy License for workplace and plan location.

Preferred Experience

  • Medicare Part D or Medicaid experience.
  • Managed care experience.

To all current Molina employees: If you are interested in applying for this position, please apply through the intranet job listing.

Molina Healthcare offers a competitive benefits and compensation package. Molina Healthcare is an Equal Opportunity Employer (EOE) M/F/D/V.

#PJPharm2

#LI-AC1

Pay Range: $80,412 - $156,803.45 / ANNUAL
*Actual compensation may vary from posting based on geographic location, work experience, education and/or skill level.

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About Molina Healthcare

Sourced by ZipRecruiter

Molina Healthcare is a nationwide fortune 500 organization with a mission to provide quality healthcare to people receiving government assistance. If you are seeking a meaningful opportunity in a team-oriented environment, come be a part of a highly engaged workforce dedicated to our mission. Bring your passion and talents and together we can make a difference in the lives of others.

Industry

Health care and social assistance

Company size

10,000+ Employees

Headquarters location

Long Beach, CA, US

Year founded

1980

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