Preferred Drug List (PDL) Pharmacist

It takes great medical minds to create powerful solutions that solve some of healthcare’s most complex challenges. Join us and put your expertise to work in ways you never imagined possible. We know you’ve honed your career in a fast-moving medical environment.

While Gainwell operates with a sense of urgency, you’ll have the opportunity to work more flexible hours. And working at Gainwell carries its rewards. You’ll have an incredible opportunity to grow your career in a company that values work-life balance, continuous learning, and career development.

Summary

As a Preferred Drug List (PDL) Pharmacist supporting the Gainwell Pricing and Contracting team, you will support the clinical, operational, and financial PDL needs of the Delaware Medicaid Fee-for-Service line of business. You will oversee the development, implementation, maintenance, and expansion of a clinically appropriate and fiscally responsible PDL while ensuring adjudication and related communications reflect current program requirements.

You will monitor changes in the drug market, develop prior authorization criteria, support therapeutic class reviews, analyze net cost and utilization trends, and collaborate across teams to effectively manage PDL-related information and programs. Your role in our mission

Serve as the primary point of contact and subject matter expert for the State of Delaware on PDL maintenance, development, expansion, and transformation, including discussions on clinical, operational, and financial impacts.

Oversee PDL operations and monitor drug launches, generics, biosimilars, discontinuations, pricing, shortages, patent expirations, Medicaid Drug Rebate Program changes, and other relevant market developments.

Develop and maintain prior authorization criteria, drug coding and status files, therapeutic class reviews, publications, and Pharmacy & Therapeutics Committee materials and deliverables.

Analyze clinical evidence, utilization, market share, net cost, and rebate considerations to develop strategic recommendations for drug coverage, therapeutic classes, and utilization management.

Present clinical and financial recommendations to clients and Pharmacy & Therapeutics Committee stakeholders, while coordinating 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, leveraging processes and technology to improve efficiency.

What We're Looking For

Active, unrestricted Registered Pharmacist license in any state.

PharmD or equivalent education and experience, with at least three years of pharmacy benefits management or managed care experience.

Knowledge of Medicaid at the state and/or federal level, including experience working in Medicaid, healthcare technology, and/or pharmacy analytics.

Experience supporting Pharmacy & Therapeutics Committee and Drug Utilization Review Board activities and managing formularies from clinical, operational, and financial perspectives.

Strong analytical, client relationship, communication, and technology skills, with the ability to translate complex clinical and business information into actionable recommendations.

What you should expect in this role

• This position is remote.
• Work hours: Eastern Time Zone
• Supports the Gainwell Pharmacy Center of Excellence (COE).
• Maintain confidentiality and comply with HIPAA and applicable Gainwell policies.

Maintain regular attendance and effective working relationships with coworkers, clients, members, providers, and customers.

The pay range for this position is 113,700.00 -162,400.00 per year, however, the base pay offered may vary depending on geographic region, internal equity, job-related knowledge, skills, and experience among other factors. Put your passion to work at Gainwell.

You’ll have the opportunity to grow your career in a company that values work flexibility, learning, and career development. All salaried, full-time candidates are eligible for our generous, flexible vacation policy, a 401(k) employer match, comprehensive health benefits, and educational assistance.

We also have a variety of leadership and technical development academies to help build your skills and capabilities.

We believe nothing is impossible when you bring together people who care deeply about making healthcare work better for everyone. Build your career with Gainwell, an industry leader. You’ll be joining a company where collaboration, innovation, and inclusion fuel our growth. Learn more about Gainwell at our company website and visit our Careers site for all available job role openings.

Gainwell Technologies is an Equal Opportunity Employer, where all qualified applicants will receive consideration for employment without regard to race, religion, color, national origin, gender (including pregnancy, childbirth, or related medical condition), age, sexual orientation, status as a protected veteran, status as an individual with a disability, or other applicable legally protected characteristics. Gainwell Technologies defines “wages” and “wage rates” to include “all forms of pay, including, but not limited to, salary, overtime pay, bonuses, stock, stock options, profit sharing and bonus plans, life insurance, vacation and holiday pay, cleaning or gasoline allowances, hotel accommodations, reimbursement for travel expenses, and benefits.