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Clinical Pharmacist – Formulary Management Regulatory

May 28, 2026

Follow us on Linkedin: https://www.linkedin.com/company/pulivarthigroup/ Pulivarthi Group LLC is a Global Staffing & IT Technology Solutions company, with our prime focus of providing world class solutions to our customers with the right talent. We combine the expertise of our team and the culture of your company to help you with the solution that is affordable and innovative using high quality standards and technologies. We’ve served some of the largest healthcare, financial services, and government entities in the U.S. Job Title: Clinical Pharmacist – Formulary Management Regulatory Company Overview Pulivarthi Group is a premier global provider of staffing and IT technology solutions, renowned for delivering exceptional services tailored to each client's unique needs. With a steadfast commitment to excellence, we merge expertise with innovation, ensuring cost-effective solutions of the highest quality. Our diverse client base spans healthcare, finance, government, and beyond, reflecting our adaptability and proficiency across industries. Operating in the United States, Canada, and Mexico, we pride ourselves on aligning with clients' cultures, deploying top-tier talent, and utilizing cutting-edge technologies. Pulivarthi Group stands as a beacon of reliability, efficiency, and innovation in the realm of staffing solutions. Job Overview/Summary We are seeking a Clinical Pharmacist – Formulary Management Regulatory to join our client’s formulary management team. This role combines clinical pharmacy expertise with regulatory compliance to ensure template formularies, utilization management (UM) criteria, and processes align with MHPAEA and federal/state regulations. The position also supports audits, market checks, and cross-functional collaboration to maintain compliance and optimize formulary strategies. Key Responsibilities Regulatory Compliance & Audits <ul><li>Ensure template formularies and UM criteria align with MHPAEA and all applicable federal/state regulations. </li><li>Support PBM market conduct examinations, CMS audits, and internal regulatory reviews. </li><li>Partner with Government Affairs, Legal, and Compliance teams to produce and validate data for exam requests. </li></ul>Formulary Management <ul><li>Develop and maintain template formularies including drug tiering and UM application that meet or exceed regulatory requirements. </li><li>Evaluate consistency in UM application across medical/surgical and mental health/substance use disorder drugs. </li><li>Identify evidentiary standards, factors, and sources supporting Non-Quantitative Treatment Limitations (NQTLs). </li><li>Provide QA and sign-off on audit responses and corrective action plans. </li></ul>Utilization Management <ul><li>Understand UM processes including prior authorization, step therapy, quantity limits, and formulary exceptions. </li><li>Ensure UM decisions reflect clinical best practices and regulatory requirements. </li></ul>Cross-Functional Collaboration <ul><li>Act as liaison between Formulary Management and internal/external stakeholders including Client Audit Team, Legal, Compliance, and Regulatory Affairs. </li><li>Collaborate in a matrixed environment with colleagues across departments and levels. </li><li>Present findings and recommendations to leadership and regulatory partners. </li></ul>Primary Skills <ul><li>Strong understanding of MHPAEA, CMS regulations, and market conduct exam processes. </li><li>Demonstrated expertise in utilization management interventions (prior authorization, step therapy, quantity limits, formulary exceptions). </li><li>Proven ability to perform literature searches and evidence-based medicine analysis. </li><li>Excellent communication skills with the ability to distill complex concepts for leadership. </li><li>Project and process management experience with ability to optimize complex workflows. </li><li>Proficiency in MS Office applications (Word, Excel, Access, PowerPoint). </li></ul>Preferred Skills (Good To Have) <ul><li>Experience supporting audits and regulatory reviews in a PBM or managed care setting. </li><li>Familiarity with mental health and substance use disorder treatment guidelines. </li><li>Knowledge of Specialty Pharmacy, Utilization Management, and Formulary Management. </li><li>Experience managing complex projects and cross-functional initiatives. </li><li>Knowledge of regulatory rules and requirements across state and federal levels. </li></ul>Qualifications <ul><li>BS in Pharmacy or PharmD required. </li><li>Active pharmacist license in good standing. </li><li>3–5 years of experience in regulatory pharmacy, utilization management, or PBM operations. </li><li>3+ years of managed care experience. </li><li>3+ years of relevant UM or prior authorization experience. </li><li>Ability to work 3 days per week onsite at Buffalo Grove, IL or Pittsburgh, PA office locations (hybrid structure). </li></ul>What We Offer <ul><li>Opportunity to work with a leading PBM and managed care organization. </li><li>Competitive salary and benefits package. </li><li>Ability to influence formulary management strategies impacting diverse populations. </li><li>A values-driven organization prioritizing compliance, innovation, and collaboration. </li></ul>Additional Requirements <ul><li>Candidates must be able to provide proof of eligibility to work in the United States. </li><li>Background check and drug screening may be required based on position requirements. </li></ul>Equal Opportunity Statement Pulivarthi Group is proud to be an equal opportunity employer. We are committed to building a diverse and inclusive culture and celebrate authenticity. We do not discriminate on the basis of race, religion, color, national origin, gender, gender identity, sexual orientation, age, marital status, disability, protected veteran status, or any other legally protected characteristics.

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Common Interview Questions And Answers

1. HOW DO YOU PLAN YOUR DAY?

This is what this question poses: When do you focus and start working seriously? What are the hours you work optimally? Are you a night owl? A morning bird? Remote teams can be made up of people working on different shifts and around the world, so you won't necessarily be stuck in the 9-5 schedule if it's not for you...

2. HOW DO YOU USE THE DIFFERENT COMMUNICATION TOOLS IN DIFFERENT SITUATIONS?

When you're working on a remote team, there's no way to chat in the hallway between meetings or catch up on the latest project during an office carpool. Therefore, virtual communication will be absolutely essential to get your work done...

3. WHAT IS "WORKING REMOTE" REALLY FOR YOU?

Many people want to work remotely because of the flexibility it allows. You can work anywhere and at any time of the day...

4. WHAT DO YOU NEED IN YOUR PHYSICAL WORKSPACE TO SUCCEED IN YOUR WORK?

With this question, companies are looking to see what equipment they may need to provide you with and to verify how aware you are of what remote working could mean for you physically and logistically...

5. HOW DO YOU PROCESS INFORMATION?

Several years ago, I was working in a team to plan a big event. My supervisor made us all work as a team before the big day. One of our activities has been to find out how each of us processes information...

6. HOW DO YOU MANAGE THE CALENDAR AND THE PROGRAM? WHICH APPLICATIONS / SYSTEM DO YOU USE?

Or you may receive even more specific questions, such as: What's on your calendar? Do you plan blocks of time to do certain types of work? Do you have an open calendar that everyone can see?...

7. HOW DO YOU ORGANIZE FILES, LINKS, AND TABS ON YOUR COMPUTER?

Just like your schedule, how you track files and other information is very important. After all, everything is digital!...

8. HOW TO PRIORITIZE WORK?

The day I watched Marie Forleo's film separating the important from the urgent, my life changed. Not all remote jobs start fast, but most of them are...

9. HOW DO YOU PREPARE FOR A MEETING AND PREPARE A MEETING? WHAT DO YOU SEE HAPPENING DURING THE MEETING?

Just as communication is essential when working remotely, so is organization. Because you won't have those opportunities in the elevator or a casual conversation in the lunchroom, you should take advantage of the little time you have in a video or phone conference...

10. HOW DO YOU USE TECHNOLOGY ON A DAILY BASIS, IN YOUR WORK AND FOR YOUR PLEASURE?

This is a great question because it shows your comfort level with technology, which is very important for a remote worker because you will be working with technology over time...

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