AffirmedRx is on a mission to improve health care outcomes by bringing clarity, integrity, and trust to pharmacy benefit management. We are committed to making pharmacy benefits easy to understand, straightforward to access and always in the best interest of employers and the lives they impact. We accomplish this by bringing total clarity to business practices, leading with clinical approaches, and utilizing state-of-the-art technology.
Join us in improving health care outcomes for all! We promise to do what’s right, always.
Position Summary:
The Formulary Management Pharmacist plays a crucial role on the Formulary Strategies Team, by being responsible for developing and maintaining formularies as well as working cross functionally to ensure operational compliance. This position will lead Pharmacy and Therapeutics committee meetings, provide clinical recommendations across drug classes, develop utilization management protocols, and monitor the drug pipeline to forecast future formulary strategies.
What you will do:
- Remain current with industry trends and provide clinical intelligence to internal teams and clients
- Monitor drug pipeline and assess new drugs to the market to determine appropriate formulary management strategies
- Develop and present clinical material at Pharmacy and Therapeutics Committee meetings, ensuring clarity and relevance
- Work closely with upstream and downstream partners on formulary decisions and updates
- Analyze large data sets to identify utilization trends/outliers and implement appropriate utilization management edits
- Investigate/resolve clinical issues and escalate issues to management as required
- Collaborate with internal and external teams to support client inquiries and provide insight on drug spend, utilization, clinical alternatives, and formulary compliance
- Assist in responding to clinical RFI and RFP questions
- Communicate formulary changes, formulary status, and clinical benefit coverage to internal and external teams
- Provide oversight of client specific formulary marketing materials
- Work with analysts to oversee clinical edit/drug list development and ensure appropriateness of formulary and clinical benefit adjudication in claims processing system
- Participate in implementation meetings and provide clinical and operational support for the transition of new clients over to AffirmedRx standard or custom formularies
- Develop formulary management programs and cost savings initiatives
- Ensure formulary is compliant with regulatory requirements
- Develop and maintain department process documents
What you Need:
- Registered pharmacist, RPh or PharmD required
- Active and unrestricted Pharmacist license
- 3-5 years of managed care or PBM experience, preferred
- Formulary management experience, preferred
- Residency/fellowship completion, preferred
- Ability to manage multiple projects at a time, required
- Analytical thinking and strong problem solving abilities
- Knowledge of pharmacy benefit design, drug utilization management, and healthcare regulations
- Strong attention to detail and accuracy in data management
- Effective communication and presentation skills to interact with cross-functional teams and clients
- Proven time management, organizational, and multi-taking skills
- Ability to work independently and collaboratively within a team
- Proven commitment to high quality work
- Proficient in Microsoft Office Suite (Word, Excel, PowerPoint, etc.)
- Willingness and ability to travel (10%-20%)
What you get:
- To impact industry change in the pharmacy benefits management space, while delivering the highest quality patient outcomes.
- To work in a culture where people thrive because when OUR team thrives, OUR business thrives.
- Competitive compensation, including health, dental, vision and other benefits.
Note:
AffirmedRx is committed to providing equal employment opportunities to all employees and applicants for employment. Remote employees are expected to maintain a professional work environment free of distractions to ensure optimal performance and collaboration.
Top Skills
What We Do
AffirmedRx, PBC, is the only Public Benefit Corporation leading the next generation of Pharmacy Benefit Management solutions for employer groups, health plans, hospital groups and other payers. We’re committed to pass through ALL pricing, discounts and rebates we have negotiated with pharma manufacturers and pharmacies to simplify and reduce prescription drug spending. Our goal is for members to have absolute access to the safest and lowest cost medications to help maintain or restore their health. The pharmacy ecosystem is complex with layers of agreements, payment models and fees. We are committed to simplifying pharmacy benefits and helping patients feel good about their benefit provider. AffirmedRx. We're All In.
