Principal Medicaid Pharmacy Strategist, PDL, Pricing & Contracting (Any city, IL

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 a Principal Medicaid Pharmacy Strategist, PDL, Pricing & Contracting at Gainwell, you will contribute your pharmacy, Medicaid, analytical, and clinical expertise to support state Medicaid pharmacy programs and the populations they serve. This role supports the development and maintenance of Medicaid Preferred Drug Lists (PDLs), clinical coverage criteria, drug cost analyses, and supplemental rebate strategies.

The ideal candidate will be a pharmacist with extensive knowledge of Medicaid pharmacy operations, including drug pricing methodologies, supplemental rebate programs, Medicaid Drug Rebate Program concepts, clinical criteria development, and pharmacy point-of-sale (POS) claims processing. This position requires a strong ability to translate complex clinical, utilization, pricing, and rebate data into actionable recommendations for Medicaid clients.

• Advanced Microsoft Excel skills and the ability to independently analyze large and complex pharmacy datasets are essential to success in this role.
• Your role in our mission
• Support Medicaid Preferred Drug List (PDL) strategy through analysis of drug products, clinical criteria, utilization, pricing, and rebate opportunities.
• Conduct financial analyses using drug pricing, utilization, and Medicaid rebate data to support formulary and coverage recommendations.
• Evaluate clinical criteria, prior authorizations, and pharmacy benefit requirements to optimize access, cost, and rebate outcomes.
• Analyze utilization, expenditures, pricing trends, and supplemental rebate offers to develop client recommendations.
• Build reports, forecasts, and analytical models using advanced Excel and large datasets.
• Present findings to clients and committees, translating complex clinical and financial data into actionable recommendations.
• Collaborate with cross-functional teams to implement PDL, rebate, and pharmacy program strategies.
• Monitor market developments, validate program data, and maintain accurate analytical documentation.

What we're looking for

Licensed Pharmacist (RPh or PharmD) in the U.S.

5+ years of pharmacy experience, including Medicaid pharmacy, managed care, PBM operations, formulary management, or related areas.

Strong knowledge of Medicaid pharmacy programs, including PDLs, utilization management, prior authorization, claims adjudication, and pharmacy benefit operations.

Experience with drug pricing, Medicaid rebates, supplemental rebates, pharmaceutical contracting, and financial analysis.

Experience developing or evaluating formularies, PDLs, prior authorization, and utilization management criteria.

Advanced Microsoft Excel skills, including analysis of large datasets and financial modeling.

Ability to translate clinical, pricing, utilization, and rebate data into sound pharmacy benefit recommendations.

Preferred: Experience supporting state Medicaid PDL programs, Medicaid supplemental rebate programs, rebate pools, or multi-state contracting initiatives.

Strong analytical and problem-solving skills with experience identifying and reconciling data discrepancies across multiple sources.

What you should expect in this role 100% Remote (U.S. only) Travel: Up to 10% Applications will be accepted through November 13, 2026.

The pay range for this position is $113,700.00 - $162,400.00 per year, however, the base pay offered may vary depending on geographic region, internal equity, job-related knowledge, skills, and experience among other factors. Put your passion to work at Gainwell. You’ll have the opportunity to grow your career in a company that values work flexibility, learning, and career development. All salaried, full-time candidates are eligible for our generous, flexible vacation policy, a 401(k) employer match, comprehensive health benefits, and educational assistance. We also have a variety of leadership and technical development academies to help build your skills and capabilities.

We believe nothing is impossible when you bring together people who care deeply about making healthcare work better for everyone. Build your career with Gainwell, an industry leader. You’ll be joining a company where collaboration, innovation, and inclusion fuel our growth. Learn more about Gainwell at our company website and visit our Careers site for all available job role openings.

Gainwell Technologies is an Equal Opportunity Employer, where all qualified applicants will receive consideration for employment without regard to race, religion, color, national origin, gender (including pregnancy, childbirth, or related medical condition), age, sexual orientation, status as a protected veteran, status as an individual with a disability, or other applicable legally protected characteristics. Gainwell Technologies defines “wages” and “wage rates” to include “all forms of pay, including, but not limited to, salary, overtime pay, bonuses, stock, stock options, profit sharing and bonus plans, life insurance, vacation and holiday pay, cleaning or gasoline allowances, hotel accommodations, reimbursement for travel expenses, and benefits.

Originally posted on Himalayas