Specialist, Formulary Operations

This is a fully remote position, open to applicants in Idaho.

📋 Description

• Execute the daily, weekly, and monthly administrative tasks required to update and maintain the formularies for Navitus’ clients across all lines of business.

• Collaborate with the Formulary Services Supervisors to implement all modifications to the formulary information accessible by clients.

• Conduct daily formulary maintenance activities.

• Provide advisory input on the presentation, maintenance, and review of this information.

• Gather formulary information from various sources, including the Pharmacy and Therapeutics Committee, the Formulary Advisory Committee, and Clinical Account Executives, to facilitate the process of entering information into the formulary change database and communicating updates to Benefits Systems and Auditing.

• Ensure that up-to-date formulary documents are available through multiple channels, including ePocrates, web portals, and e-prescribing.

• Analyze weekly Medispan Reports for new drugs and changes that affect the formulary.

• Work in conjunction with clinical and client services during new client implementations to gather the formulary information necessary for plan setup.

• Address various formulary/setup inquiries.

• Estimated travel requirement (5-10%).

• Perform additional duties as assigned.

⛳️ Requirements

• A minimum of a High School diploma along with knowledge related to pharmacy practice is required.

• CPhT or experience as a pharmacy technician is highly preferred.

• Previous experience with pharmacy claims software is an advantage.

• Must possess a working knowledge of pharmacy practice, including drug names (brand vs. generic, NDC, GPI) and claims processing background (either from managed care or community practice).

• Familiarity with formulary, prior authorization, step therapy, and other utilization management tools is preferred.

• Strong computer skills, particularly in Excel, Word, and Outlook.

• Excellent communication skills, both verbal and written.

• Ability to work effectively both independently and as part of a team.

• Capable of exercising appropriate judgment as necessary.

• A high level of initiative and creativity is required.

• Commitment to participating in, adhering to, and supporting compliance program objectives.

• Must consistently interact cooperatively and respectfully with other employees.

🏝️ Benefits

• Competitive industry benefits for Health, Dental, and Vision insurance.

• 20 days of paid time off.

• 4 weeks of paid parental leave.

• 9 paid holidays.

• 401K company match of up to 5% with no vesting requirement.

• Adoption Assistance Program.

• Flexible Spending Account.

• Educational Assistance Plan and Professional Membership support.

• Referral Bonus Program – up to $750!