PBM - Formulary Operations Manager - Health Exchange

• Position ID #: PBM072925RXOPS
• Location: Various Cities
• Required Education: PharmD
• Salary Range: $135,000 - $145,000
• Required Experience: Two-Four Years
• Commission Range: N/A
• Other: Bonus, Equity, Benefits
• Required Travel: N/A
• Relocation: N/A
• 
  Description:
  One of the PBM Industry’s fastest-growing players is seeking a strategic, client-focused PharmD Formulary Operations Manager professional responsible for providing operational support for the evaluation, implementation, and maintenance of our standard and custom Commercial and Exchange formularies and utilization management
   
  Some of the position responsibilities include:
   
  • Define, configure, and maintain standard and custom formularies for the Health Plans and Health Information Marketplace/Exchange lines of business 
  • Provide client-facing strategic and operational support for the configuration, implementation, maintenance, and quality control of custom formularies, drug lists, custom formulary marketing materials, clinical adjudication lists, and utilization management edits 
  • Collaborates with teams in a cross-functional environment including, but not limited to; benefit administration, rebate administration, client account management, analytics, software development/product, regulatory/compliance, government programs, member experience, prior authorization operations, and marketing 
  • Analyze pharmacy cost of care, clinical updates, and coordinate the development of appropriate formulary management programs and utilization management edits 
  • Support formulary change-processes within URAC/NCQA/SOC guidelines and requirements 
   
  The compensation plan includes a salary, ranging from $135,000- $145,000 (do/e), plus bonus, equity, expenses, and benefits.
  
  This position can be filled remotely
• 
  Requirements:
  The ideal candidate for this position must be a PharmD from an accredited institution, with record of strong academic performance.
  • Current, unrestricted registered pharmacist license(s) 
  • Extensive knowledge and insight into Health Plans and Health Information Marketplace/Exchanges
  • 2-3 years of formulary experience working for a health plan or PBM preferred 
  • Knowledge of formulary development and maintenance processes 
  • Knowledge of highly managed specialty medications/strategy 
  • Knowledge of rebate and financial implications of formulary strategies 
  • Ability to independently identify, research, and resolve issues 
  • Ability to balance multiple complex projects simultaneously 
  
  Qualified candidates should send their resumes in MS Word format to: mail@phoenixhealthsearch.com
    
  Visit: www.phoenixhealthsearch.com