Senior Consultant, Medicare Part D Pharmacy

Introduction At Gallagher Benefit Services, you’re a trusted partner to organizations navigating some of their most important people decisions. We help clients build better workplaces, where people feel supported, empowered, and inspired to thrive. Whether it’s shaping benefit strategies, designing wellbeing programs, or advising on workforce challenges, the work you do here creates meaningful change for businesses and the people who power them. We’re a community of bold explorers, trusted experts, and compassionate partners; working side by side to solve problems, and shape the future of work. Here, curiosity is encouraged, collaboration is second nature, and your ideas have room to grow. If you’re looking for a place where your contribution matters and where you can help build a better world of work; think of Gallagher. Overview Join Gallagher as a Senior Consultant specializing in Medicare Part D Pharmacy. In this role, you’ll provide expert consulting support to help clients navigate Medicare Part D operations, formulary administration, and regulatory compliance. You’ll partner with clients and internal teams to design, optimize, and maintain pharmacy programs that align with CMS requirements and deliver sustainable results. This is a dynamic role where your expertise will drive operational excellence and improve plan performance. How you'll make an impact As a trusted advisor, you’ll: Serve as a subject matter expert in Medicare Part D plan and pharmacy operations, with emphasis on formulary development, administration, and benefit design. Provide strategic and operational guidance on formulary management, including CMS requirements, submission processes, and ongoing maintenance. Support Pharmacy & Therapeutics (P&T) Committee activities, including governance, documentation, regulatory compliance, and operational execution. Advise on plan-level operational processes impacting formulary administration, utilization management, and beneficiary access. Support CMS Program Audits with a primary focus on Formulary Administration and Coverage Determinations, Appeals, and Grievances (CDAG). Develop, update, and maintain policies, procedures, and work plans related to Part D plan and formulary operations. Oversee and administer ongoing monitoring programs to ensure continued compliance with CMS guidance. Monitor and guide implementation of corrective action plans, ensuring sustainable operational and regulatory outcomes. Mentor team members and guide work products using structured project management methodologies. Manage client communications, expectations, and deliverables while providing high-quality consultative service. Support client interim staffing needs as required. Travel as required to support client engagements. About You Here's what you'll bring to the role: Working knowledge of Part D claims adjudication and Prescription Drug Event (PDE) processing to support plan operations, issue identification, and regulatory compliance. Bachelor’s degree or Doctor of Pharmacy (PharmD) required; active Pharmacist license required. Minimum of 10 years of experience in healthcare, government programs, PBM operations, compliance, quality, or related fields. Extensive experience with Medicare Part D plan operations, formulary development and administration, and P&T Committee processes. Strong knowledge of Medicare and/or Medicaid regulatory standards. Advanced proficiency in Microsoft Word, Excel, Access, and PowerPoint. Ability to communicate complex regulatory and operational concepts clearly to internal and external stakeholders. Strong organizational, analytical, and problem-solving skills with the ability to work independently and manage multiple priorities under tight timelines. Preferred Qualifications: Experience with PACE plans and/or 340B programs. Experience with Medicaid and Exchange pharmacy operations and regulations. Experience supporting Medicare Star Ratings pharmacy measures, including medication adherence and quality improvement initiatives. Familiarity with Medication Therapy Management (MTM) program design, operations, or performance monitoring within Medicare Part D. Advanced degree or professional certification in pharmacy, compliance, audit, or a related discipline. Compensation and benefits We offer a competitive and comprehensive compensation package. The base salary range represents the anticipated low end and high end of the range for this position. The actual compensation will be influenced by a wide range of factors including, but not limited to previous experience, education, pay market/geography, complexity or scope, specialized skill set, lines of business/practice area, supply/demand, and scheduled hours. On top of a competitive salary, great teams and exciting career opportunities, we also offer a wide range of benefits. Below are the minimum core benefits you’ll get, depending on your job level these benefits may improve: Medical/dental/vision plans, which start from day one! Life and accident insurance 401(K) and Roth options Tax-advantaged accounts (HSA, FSA) Educational expense reimbursement Paid parental leave Other benefits include: Digital mental health services (Talkspace) Flexible work hours (availability varies by office and job function) Training programs Gallagher Thrive program – elevating your health through challenges, workshops and digital fitness programs for your overall wellbeing Charitable matching gift program And more... **The benefits summary above applies to fulltime positions. If you are not applying for a fulltime position, details about benefits will be provided during the selection process. We value inclusion and diversity Click Here to review our U.S. Eligibility Requirements Inclusion and diversity (I&D) is a core part of our business, and it’s embedded into the fabric of our organization. For more than 95 years, Gallagher has led with a commitment to sustainability and to support the communities where we live and work. Gallagher embraces our employees’ diverse identities, experiences and talents, allowing us to better serve our clients and communities. We see inclusion as a conscious commitment and diversity as a vital strength. By embracing diversity in all its forms, we live out The Gallagher Way to its fullest. Gallagher believes that all persons are entitled to equal employment opportunity and prohibits any form of discrimination by its managers, employees, vendors or customers based on race, color, religion, creed, gender (including pregnancy status), sexual orientation, gender identity (which includes transgender and other gender non-conforming individuals), gender expression, hair expression, marital status, parental status, age, national origin, ancestry, disability, medical condition, genetic information, veteran or military status, citizenship status, or any other characteristic protected (herein referred to as “protected characteristics”) by applicable federal, state, or local laws. Equal employment opportunity will be extended in all aspects of the employer-employee relationship, including, but not limited to, recruitment, hiring, training, promotion, transfer, demotion, compensation, benefits, layoff, and termination. In addition, Gallagher will make reasonable accommodations to known physical or mental limitations of an otherwise qualified person with a disability, unless the accommodation would impose an undue hardship on the operation of our business. As a trusted advisor, you’ll: Serve as a subject matter expert in Medicare Part D plan and pharmacy operations, with emphasis on formulary development, administration, and benefit design. Provide strategic and operational guidance on formulary management, including CMS requirements, submission processes, and ongoing maintenance. Support Pharmacy & Therapeutics (P&T) Committee activities, including governance, documentation, regulatory compliance, and operational execution. Advise on plan-level operational processes impacting formulary administration, utilization management, and beneficiary access. Support CMS Program Audits with a primary focus on Formulary Administration and Coverage Determinations, Appeals, and Grievances (CDAG). Develop, update, and maintain policies, procedures, and work plans related to Part D plan and formulary operations. Oversee and administer ongoing monitoring programs to ensure continued compliance with CMS guidance. Monitor and guide implementation of corrective action plans, ensuring sustainable operational and regulatory outcomes. Mentor team members and guide work products using structured project management methodologies. Manage client communications, expectations, and deliverables while providing high-quality consultative service. Support client interim staffing needs as required. Travel as required to support client engagements. Here's what you'll bring to the role: Working knowledge of Part D claims adjudication and Prescription Drug Event (PDE) processing to support plan operations, issue identification, and regulatory compliance. Bachelor’s degree or Doctor of Pharmacy (PharmD) required; active Pharmacist license required. Minimum of 10 years of experience in healthcare, government programs, PBM operations, compliance, quality, or related fields. Extensive experience with Medicare Part D plan operations, formulary development and administration, and P&T Committee processes. Strong knowledge of Medicare and/or Medicaid regulatory standards. Advanced proficiency in Microsoft Word, Excel, Access, and PowerPoint. Ability to communicate complex regulatory and operational concepts clearly to internal and external stakeholders. Strong organizational, analytical, and problem-solving skills with the ability to work independently and manage multiple priorities under tight timelines. Preferred Qualifications: Experience with PACE plans and/or 340B programs. Experience with Medicaid and Exchange pharmacy operations and regulations. Experience supporting Medicare Star Ratings pharmacy measures, including medication adherence and quality improvement initiatives. Familiarity with Medication Therapy Management (MTM) program design, operations, or performance monitoring within Medicare Part D. Advanced degree or professional certification in pharmacy, compliance, audit, or a related discipline.