Specialist, Formulary Operations
Madison, WI, United States
Company
NavitusAbout Us
Navitus - Putting People First in Pharmacy - Navitus was founded as an alternative to traditional pharmacy benefit manager (PBM) models. We are committed to removing cost from the drug supply chain to make medications more affordable for the people who need them. At Navitus, our team members work in an environment that celebrates diversity, fosters creativity and encourages growth. We welcome new ideas and share a passion for excellent service to our customers and each other.Pay Range
USD $19.60 - USD $23.06 /Hr.Work Schedule Description (e.g. M-F 8am to 5pm)
M-F 8am to 5pmRemote Work Notification
ATTENTION: We are unable to offer remote work to residents of Alaska, Hawaii, Maine, Mississippi, New Hampshire, New Mexico, Rhode Island, South Carolina, South Dakota, West Virginia, and Wyoming.Overview
Navitus Health Solutions is seeking a Specialist, Formulary Operations to join our team!
The Specialist, Formulary Operations will perform the daily, weekly, and monthly/periodic administrative functions necessary to update and maintain the formularies for Navitus’ clients for all lines of business. This includes working with the Formulary Services Supervisors to make all changes to the formulary information accessed by clients, as well as day to day formulary maintenance; and having advisory input to how this information is presented, maintained, and reviewed.
Is this you? Find out more below!
Responsibilities
How do I make an impact on my team?
- Take formulary information from various sources including the Pharmacy and Therapeutics Committee, the Formulary Advisory Committee, and Clinical Account Executives to coordinate the process of entering the information into the formulary change database and communicating changes to Benefits Systems and Auditing
- Maintain up-to-date formulary documents available through multiple resources including ePocrates, web portals, and e-prescribing
- Review weekly Medispan Reports for new drugs and drug changes that impact the formulary
- Collaborate with clinical and client services throughout new client implementations to capture the formulary information needed for plan set-up
- Trouble-shoot various formulary / set-up questions
- Approximate travel required (5-10%)
- Other duties as assigned
Qualifications
What our team expects from you?
- A minimum of a High School diploma plus knowledge relating to pharmacy practice is required
- CPhT/experience as a pharmacy technician strongly preferred
- Previous experience with pharmacy claims software is a definite plus
- Must have 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 preferred
- Strong computer skills (Excel, Word, Outlook)
- Strong communication skills (verbal and written)
- Needs to work well both independently and in a team setting
- Must be able to exercise appropriate judgment as necessary
- Requires a high level of initiative and creativity
- Participate in, adhere to, and support compliance program objectives
- The ability to consistently interact cooperatively and respectfully with other employees
We are unable to offer remote work to residents of Alaska, Hawaii, Maine, Mississippi, New Hampshire, New Mexico, North Dakota, Rhode Island, South Carolina, South Dakota, West Virginia, and Wyoming.
Location : Address
361 Integrity DriveLocation : City
MadisonLocation : State/Province
WILocation : Postal Code
53717Location : Country
US ApplyJob Profile
Hawaii Maine Mississippi New Hampshire New Mexico No remote work for residents of certain states Rhode Island South Carolina South Dakota West Virginia Wyoming
Benefits/Perks20 days paid time off 20 Days PTO 401k company match 401(k) match 4 weeks 4 weeks paid parental leave 4 weeks parental leave 9 Paid Holidays Adoption Assistance Creativity Dental Insurance Diversity Flexible Spending Account Health insurance Paid holidays Paid parental leave Paid Time Off Remote work Vision Insurance
Tasks- Collaborate on client implementations
- Coordinate formulary changes
- Maintain formularies
- Review medispan reports
Auditing Claims processing Client Services Communication Compliance Creativity Excel Formulary management Health Initiative Insurance Outlook Pharmacy Claims Pharmacy claims software Pharmacy Practice Prior authorization Teamwork Utilization management Word
Experience0 years
Education Certifications TimezonesAmerica/Anchorage America/Chicago America/Denver America/Los_Angeles America/New_York Pacific/Honolulu UTC-10 UTC-5 UTC-6 UTC-7 UTC-8 UTC-9