Renew Health’s mission is to fundamentally transform how medications are managed in the health care system. To do so, we are building a modern and flexible tech stack that will anchor a highly differentiated approach to pharmacy benefits. This technology will power an innovative set of clinical services and exceptional member experience, which together can improve access, increase adherence, and ensure that members maximize the clinical benefit they receive from medications.
We believe that our approach will reduce population costs, decrease medication errors, and dramatically improve clinical outcomes. It will also allow us to align our business model with the interests of health plans and patients--passing through savings to clients and members, and generating revenue through clinical services that improve care and lower costs.
Our initial team of 30 includes co-founders of Oscar, Devoted, and Lyra Health, and alumni of top companies including Microsoft, Amazon, McKinsey, Snapchat, DaVita, Google, Cityblock Health, Appnexus, The New York Times, and GoodRx. To date, Renew Health has raised $13M of funding, led by Venrock.
About the role:
Renew Health is seeking an experienced Formulary Pharmacist to help build one of the key differentiating components of our business--an innovative approach to formulary design that lowers the total cost of care and maximizes health for our members, approaches prescriber utilization management and behavior change creatively, and develops highly effective clinical services.
Reporting to the Chief Pharmacist, you will oversee the development, administration, and day to day management of the Medicare Part D drug formulary, while playing a critical role in the development and implementation of Renew Health’s long-term formulary strategy. You will also be broadly responsible for monitoring the drug development pipeline, medical compendia and publications, as well as provide clinical support for internal parties and external clients.
- Develop and operationalize formularies related to coverage, utilization management edits, or clinical coverage policies
- Help guide our long-term approach for developing an innovative formulary that ensures access for our members, manages costs for our clients, and supports our broader clinical vision
- Participate in Pharmacy and Therapeutic Committee including assisting with monograph development and presentation
- Upload and monitor HPMS formulary files and line level responses
- Develop internal and external communications demonstrating industry drug trends
- Assist in analysis of drug spend, utilization, and/or approval scenarios with rebate and financial teams
- Collaborate with product team on development of printed formulary and formulary search tool
- Manage the monthly and annual negative formulary change process
- Be the key driver for issue investigation and remediation specific to formulary issues
- Conduct oversight and monitoring of drug management programs and patient safety initiatives
- Degree of Doctor of Pharmacy (PharmD or RPh) from an accredited School of Pharmacy and active pharmacy licensure
- Three years experience in pharmacy benefit management and Medicare Part D clinical operations
- Experience working with Medicare Part D formularies at a PBM or health plan
- Extensive knowledge of Federal and State pharmacy regulations, the Medicare Part D Program, and interpreting implementing, and complying with CMS guidance and regulations
- Strong process improvement, project management, and organizational skills
- Ability to assimilate, analyze, draw conclusions, and make recommendations from complex data
- Desire to join an early-stage company with a bold vision for making a fundamental transformation in a historically-fraught area of the healthcare industry
- Ability to thrive in an entrepreneurial, fast-paced environment with limited resources
- Sense of humor and humility
- Willingness to relocate to Los Angeles (if living elsewhere)