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Formulary Operations Pharmacist – Medicare - Remote

Posted 6 days ago
All others
Full Time
USA
$125,000 - $135,000 USD/year

Overview

The Formulary Operations Pharmacist – Medicare is responsible for providing operational support for the evaluation, implementation, and maintenance of Medicare Part D formularies and utilization management.

In Short

  • Maintain standard and custom formularies for Medicare in accordance with CMS guidelines
  • Support development and quality control of Medicare Part D formularies
  • Lead preparation of CMS formulary submissions and member formulary drug lists
  • Evaluate drugs and make formulary positioning recommendations
  • Support comprehensive testing of client formulary elections
  • Monitor and analyze regulatory requirements for Medicare
  • Lead formulary change processes within URAC/NCQA/CMS guidelines
  • Participate in Pharmacy and Therapeutics Committee as an ad hoc member
  • Conduct formulary reviews and develop drug monographs
  • Support quality improvement projects as needed

Requirements

  • Doctor of Pharmacy (PharmD) Degree from an accredited institution
  • Current, unrestricted registered pharmacist license(s)
  • 2-3 years of formulary experience preferred
  • Knowledge of formulary development processes
  • Ability to independently identify and resolve issues
  • Exceptional written and verbal communication skills
  • Microsoft office suite proficiency required

Benefits

  • Flexible work environment
  • Opportunity to work on impactful healthcare solutions
  • Collaboration with cross-functional teams
  • Professional development opportunities
  • Health and wellness benefits

C.R

Capital Rx

Capital Rx is a health technology company dedicated to providing innovative claim administration and technology solutions for carriers, health plans, third-party administrators, employer groups, and government entities. As a public benefit corporation, Capital Rx aims to significantly reduce healthcare costs through its full-service pharmacy benefit management (PBM) services and the deployment of Judi®, a cloud-native enterprise health platform. Judi integrates all aspects of the healthcare ecosystem into a single, efficient, and scalable platform, serving millions of members across Medicare, Medicaid, and commercial plans. The company is committed to reimagining benefits administration and rebuilding trust in healthcare while fostering a diverse and inclusive workplace.

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