Director, Pharmacy Clinical Strategy(Preferred Experience in Medical Drug Management Strategy)
Job Overview
Location
Remote
Job Type
Full-time
Category
HR & Recruiting
Date Posted
June 20, 2026
Full Job Description
📋 Description
- • The Director, Pharmacy Clinical Strategy leads the strategic development of formulary management best practices and market-competitive formulary and medical drug strategies across all CareSource lines of business and markets, ensuring alignment with organizational goals and regulatory standards.
- • Day to day, the role involves overseeing formulary and medical drug management teams, monitoring drug development pipelines, managing pharmacy benefit and medical benefits, configuring and testing pharmacy contracts in medical claims systems, developing KPIs for cost and utilization metrics, leading Clinical Programs, collaborating with stakeholders on drug utilization strategies, preparing materials for Pharmacy & Therapeutics and Value Assessment Committees, ensuring regulatory compliance for Medicaid, Medicare, and Exchange lines, analyzing data for process improvements, managing staff through hiring, training, coaching, and performance appraisals, and supporting appeals and grievance teams to reduce inappropriate cases.
- • The team operates within CareSource Management Group Company, a mission-driven healthcare organization focused on improving member health outcomes through innovative pharmacy and medical benefit strategies, with a commitment to compliance, collaboration, and continuous improvement across multiple states and lines of business.
- • In this role, the individual can develop advanced expertise in formulary and medical drug strategy, strengthen leadership and change management skills, gain deep experience in healthcare regulatory environments (Medicare, Medicaid, Marketplace), drive measurable cost savings and quality improvements, influence enterprise-wide clinical policies, and build strategic partnerships across internal and external stakeholders while contributing to better member health outcomes.
🎯 Requirements
- • Bachelor's degree in Pharmacy required
- • Three (3) years of managed care experience required
- • Two (2) years of formulary management experience in Medicare, Marketplace or Medicaid lines of business required
- • Unrestricted registered pharmacist (RPh) Licensure in state of practice required
- • Previous managerial experience required
- • Experience participating in or leading a P&T Committee required
Skills & Technologies
See exactly how your profile matches this role — strengths, skill gaps, and what to do about them.
About CareSource Management Group Company
CareSource is a nonprofit, multi-state managed care organization headquartered in Dayton, Ohio. Founded in 1989, it administers Medicaid, Medicare Advantage, and Marketplace health plans serving over two million members in Ohio, Kentucky, Indiana, West Virginia, and Georgia. The company focuses on improving health outcomes for low-income and vulnerable populations through integrated care management, behavioral health services, and social determinants programs.
Subscribe to the weekly newsletter for similar remote roles and curated hiring updates.
Newsletter
Weekly remote jobs and featured talent.
No spam. Only curated remote roles and product updates. You can unsubscribe anytime.
Similar Opportunities
Crusoe Energy Systems LLC
1 month ago
Cohere Inc.
22 days ago
Beghou Consulting Group LLC
3 months ago