Drug List; PDL Pharmacist

Position: 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 part of the Gainwell Pricing and Contracting team, the Preferred Drug List (PDL) Pharmacist supports the clinical, operational and financial PDL needs of the Delaware (DE) Medicaid Fee-for-Service line of business. This role manages the implementation, maintenance and expansion of the PDL and ensures that adjudication and related communications reflect the latest changes. The primary responsibility is the development and maintenance of a clinically appropriate and fiscally responsible PDL. Fulfilling this objective entails the following activities: monitoring drug file-related changes such as new drugs, new generics, discontinuations and their impact; developing PDL-related prior authorization criteria; identifying needed therapeutic class reviews (TCRs) and assisting with their creation and update; analyzing net cost comparisons; and monitoring Client utilization and market share trends. Additional tasks include efficiently operationalizing the program; identifying areas for improvement; and working cross-functionally to implement, update, and maintain PDL-related information in the Pharmacy Services Module. Job Functions

• Act as primary point of contact for the State of DE for PDL management, development, and transformation
• Provide PDL subject matter expertise and troubleshoot PDL-related issues
• Lead weekly client meetings reviewing clinical, operational, and financial PDL impacts
• Monitor drug market changes affecting the PDL, including new drugs/generics, pricing, MDRP updates, and shortages
• Manage prior authorization criteria and PDL drug/status coding
• Prepare and maintain PDL publications and meeting materials
• Participate in and support clinical, financial, and P&T Committee drug reviews
• Present complex clinical information clearly to clients and stakeholders
• Develop strategic recommendations for drugs, therapeutic classes, and utilization management
• Serve as liaison between internal teams and external pharmacy stakeholders
• Analyze clinical and net cost data (including rebates) to support PDL decisions
• Support PDL-related financial programs and maintain desk-level procedures
• Use OOTB technology to support efficient PDL operations

What we're looking for (Top 5)

• Excellent public speaking abilities
• Proven experience managing formularies from clinical, operational and financial perspectives
• Strong personal computer and business solutions software skills
• Proven ability to interact with varied internal and external stakeholders
• Proven ability to interface with and manage Account and Client relationships

Additional Skills

• Pharm

D or commensurate experience

• 3+ years of experience in pharmacy benefits management or managed care
• Experience working in Medicaid, healthcare technology, and/or pharmacy analytics is required
• Deep clinical and operational expertise
• Excellent verbal and written communication skills
• Ability to abide by Gainwell policies
• Ability to maintain attendance to support required quality and quantity of work
• Maintain confidentiality and comply with Health Insurance Portability and Accountability Act (HIPAA).
• Ability to establish and maintain positive and effective work relationships with coworkers, clients, members, providers, and customers
• Ability to develop, organize, and maintain project plans and agendas

What you should expect in this role

• Remote
• Work Hours:

Eastern Time Zone

• Supports Gainwell Pharmacy Center of Excellence (COE)

Applications for this posting will be accepted until January 30, 2026. The pay range for this position is$-$ per year, however, the base pay offered may vary depending on geographic region, internal equity, job-related knowledge,… Apply tot his job Apply To this Job