Position Purpose: Define and develop standard and custom formularies for assigned plan.
Key Details: Indiana Clinical Pharmacist (Formulary & Quality). This is a remote opportunity for an Indiana-licensed Pharmacist working Monday through Friday on a daytime Eastern Time schedule. There are two open Clinical Pharmacist positions that support Indiana Medicaid pharmacy operations through either a Formulary & Policy focus or a Quality & Clinical Programs focus, with opportunities for collaboration and cross-coverage between the roles. Responsibilities include leading formulary, prior authorization, and clinical policy initiatives; supporting quality improvement and medication-related clinical programs; analyzing pharmacy and performance data; developing policies, workflows, educational materials, and communications; and partnering with cross-functional teams, providers, and vendors to implement state-driven and quality-focused initiatives. The ideal candidate will have experience in managed care, Medicaid, health plans, PBMs, formulary management, prior authorization, quality improvement, specialty drug management and/or population health and demonstrate strong clinical judgment, written communication, project management, data analysis, and collaboration skills. Success in this role requires the ability to manage competing priorities, translate complex requirements into actionable solutions, identify risks, and consistently deliver accurate, audit-ready work. This opportunity offers meaningful ownership, visibility, and the chance to directly impact member access, medication safety, quality outcomes, and regulatory compliance within Indiana Medicaid pharmacy programs.
- Develop clinical criteria for medications, recommend plan design changes, and clinical programs to be initiated
- Monitor prior authorization requests
- Provide clinical support to internal departments and address clinical related questions
- Ensure appropriate quality controls and initiates opportunities for performance improvement in pharmacy/practice
- Develop and implement programs designed to impact DUR for both Medicaid and Medicare
- Develop, implement, and maintain policies and procedures for the pharmacy department
- Participate in the coordination of the Medicare MTM program
- Assist case management team with members including clinical rounds presentations
Education/Experience: Bachelor's degree or advanced degree (Pharm.D., M.S.) in pharmacy. 2+ years of mail order, retail, hospital or managed care pharmacy experience or 1+ years of pharmacy residency program experience. Specialty drug management experience, preferred
Licenses/Certifications: Current Indiana Pharmacist license with no restrictions.
Pay Range: $107,700.00 - $199,300.00 per year
Centene offers a comprehensive benefits package including: competitive pay, health insurance, 401K and stock purchase plans, tuition reimbursement, paid time off plus holidays, and a flexible approach to work with remote, hybrid, field or office work schedules. Actual pay will be adjusted based on an individual's skills, experience, education, and other job-related factors permitted by law, including full-time or part-time status. Total compensation may also include additional forms of incentives. Benefits may be subject to program eligibility.
