Job Description
Hi, we’re Gravie. Our mission is to create health benefits that actually benefit small and midsize businesses and their employees. Our innovative benefit solutions and services are developed and delivered by a diverse group of unique people. We encourage you to be your authentic self - we like you that way.
A Little More About the Role:
We’re seeking a strategic, hands-on pharmacy leader to own clinical oversight of our PBM and pharmacy vendors, drive formulary and UM strategy, and provide clinical expertise to shape our pharmacy affordability programs. This role bridges clinical expertise and operational execution to drive sustainable pharmacy spend and strong member outcomes.
You will:
● Serve as the primary pharmacy clinical lead for our PBM partnership, including oversight of utilization management, formulary and clinical programs
● Design, implement and manage clinical programs that drive affordability, quality, and member outcomes
● Provide clinical oversight of pharmacy vendors and clinical programs that improve outcomes and reduce unnecessary utilization
● Own formulary design and maintenance, including tier strategy, drug placement, therapeutic class management, and clinical edit logic
● Complete reviews of prior authorization decisions and appeals for specialty and non-specialty drugs
● Develop and maintain policies related to clinical pharmacy and both pharmacy and medical benefit drugs
● Collaborate with actuarial, finance, and product teams to inform pricing, trend modeling, pharmacy spend forecasting, and stop-loss considerations
● Partner cross-functionally with product, clinical, network, actuarial and other stakeholders to ensure integrated care approaches
● Ensure compliance with applicable regulatory, accreditation, and clinical governance standards, maintaining high ethical and quality standards
You bring:
● PharmD degree and active, unrestricted pharmacist license required
● 5+ years of pharmacy experience in clinical operations, utilization management, or formulary leadership
● Demonstrated experience in contracting oversight or performance evaluation with PBMs or pharmacy vendors
Extra credit:
● Experience working within commercial level-funded health plans and/or innovative health insurers (e.g., startup or growth-stage plans)
Gravie:
In order to transform health insurance and build a health plan everyone can love, we need talented people doing amazing work. In exchange, we offer a great overall employee experience with opportunities for career growth, meaningful mission-driven work, and an above average total rewards package.
The salary range for this position is $142,500 - $237,500 annually. Numerous factors including, but not limited to, educations, skills, work experience, certifications, etc. will be considered when determining compensation.
Our unique benefits program is the gravy, i.e., the special sauce that sets our compensation package apart. In addition to standard health and wellness benefits, Gravie’s package includes alternative medicine coverage, flexible PTO, up to 16 weeks paid parental leave, paid holidays, a 401k program, cell phone reimbursement, transportation perks, education reimbursement, and 1 week of paid paw-ternity leave.
A Little More About Us:
● We know healthcare. Our company was founded and is still led by industry veterans who have started and grown several market-leading companies in the space.
● We have raised money from top tier investors who share the same long-term vision as we do of building an industry defining company that will endure over the long run. We are well capitalized.
● Our clients love us. Customer satisfaction rates among employees using Gravie health plans consistently rank above 80% – nearly 40 points above the industry average.
● Our culture is unique. We tend to be non-hierarchical, merit-driven, opinionated but kind people who thrive working in a high-performance, fast-paced environment. People at Gravie care deeply about making a positive impact in the lives of the people we serve. We may not be the right place for everybody, but if you get energized by doing work every day that focuses on putting consumers at the front of the line, we could be a great place for you. It takes unique people and diverse perspectives to deliver our results. We encourage you to be your authentic self – we like you that way.
We may use artificial intelligence (AI) tools to support parts of the hiring process, such as reviewing applications, analyzing resumes, or assessing responses. These tools assist our recruitment team but do not replace human judgment. Final hiring decisions are ultimately made by humans. If you would like more information about how your data is processed, please contact us.
