Associate Director, Formulary Operations

Position Responsibilities:

• Oversee the development and maintenance of custom formularies for all non-Medicare lines of business including Commercial, Medicaid, and Health Information Marketplace/Exchange
• Monitor and analyze regulatory and legislative requirements, develop project plans to meet requirements, and lead cross functional teams to implement programs to meet requirements
• Oversee the implementation and maintenance of custom and standard formularies
• Supports relationship with external partners/vendors (P&T, rebate aggregator, formulary management tool, etc.)
• Facilitate communication to and education of clients, members, and internal staff regarding clinical issues and objectives
• Supervise and coach direct reports in the performance of their duties including performance reviews and feedback to direct reports
• Develop clinical criteria for review of non-formulary or non-preferred drug lists and communicate recommendations to clients
• Evaluate drugs/drug classes and make formulary positioning and utilization management recommendations and formulary management strategies
• Provide support to operational teams and clients during implementation
• Analyze and interpret prescription claims data to identify opportunities to improve existing formulary management strategies
• Supports quality improvement and clinical value projects, as required
• Support Pharmacy and Therapeutics (P&T) committee items, as required
• Support RFI and RFP submissions, as required
• Support general business needs and operations, as required
• Responsible for adherence to the Capital Rx Code of Conduct including reporting of noncompliance.

Qualifications/Profile:

• Doctor of Pharmacy (PharmD) Degree from an accredited institution, with record of strong academic performance
• Current, unrestricted registered pharmacist license(s)
• Residency/fellowship preferred
• 6-8 years of pharmacy experience working for a health plan or PBM
• Knowledge of highly managed specialty medications/strategy, formulary development and maintenance process, and pharmacy vs. medical medications
• Proficient in Microsoft Office with emphasis on Microsoft Excel and Microsoft PowerPoint
• Experience working with large datasets preferred
• Ability to balance multiple complex projects simultaneously
• Exceptional written and verbal communication skills
• Extremely flexible, highly organized, and able to shift priorities easily
• Attention to detail & commitment to delivering high quality work product

This position description is designed to be flexible, allowing management the opportunity to assign or reassign duties and responsibilities as needed to best meet organizational goals.

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