Formulary Operations Pharmacist

Posted Yesterday
Be an Early Applicant
3 Locations
In-Office
125K-135K Annually
Junior
Healthtech
The Role
Supports formulary operations with emphasis on low-cost alternative programs, including evaluating medications, analyzing claims and savings data, maintaining drug lists and dashboards, supporting formulary disruptions and implementations, and responding to client, sales, and RFP requests. Partners with clinical, analytics, product, benefits, underwriting, and account teams to improve workflows, reporting, clinical appropriateness, and program performance.
Summary Generated by Built In
About Judi Health

Judi Health is a health technology company providing benefit administration solutions to employers, unions, health plans, and government entities. Judi Health replaces fragmented, outdated systems with the industry's first Unified Claims Processing™ architecture, seamlessly consolidating pharmacy and medical benefit administration on a single, secure platform. By delivering true price transparency, eliminating unnecessary middleman fees, and leveraging advanced AI-powered care delivery, Judi Health helps clients achieve unprecedented operational efficiency and service levels.
At Judi Health, we're deploying the infrastructure our country needs to deliver the healthcare we all deserve. We are the intelligence platform powering benefits plans for millions of Americans and proudly leading the next generation of care. To learn more, visit www.judi.health.

Location: Hybrid (Local to Charlotte, NC; Denver, CO; or New York, NY area)

Position Overview

We are seeking a detail-oriented and collaborative Formulary Operations Pharmacist to support clinical and operational initiatives across Judi Rx, with a primary focus on the low-cost alternative program. This role will help maintain and expand clinically appropriate low-cost alternative opportunities, support program reporting and performance tracking, and partner cross-functionally to improve workflows that drive savings for members and plan sponsors. The pharmacist will also continue to support formulary disruption, implementation of new formularies, standard commercial formulary operations, sales-related requests, and other Formulary Operations priorities as needed.


Key Responsibilities

  • Support day-to-day management and ongoing optimization of the low-cost alternative program, including maintenance of target drug and alternative lists.
  • Evaluate high-cost medications and identify clinically appropriate, formulary-aligned lower-cost alternatives that may reduce spend for members and plan sponsors.
  • Analyze claims data, test claim results, opportunity volume, savings outputs, and intervention results to monitor program performance, identify trends, and support dashboard creation and maintenance for the low-cost alternative program and other formulary-focused initiatives.
  • Partner with Product, Analytics, Clinical Programs, Benefits, and other internal teams to improve low-cost alternative program logic, implementation workflows, reporting, and member/prescriber engagement processes.
  • Support client-specific low-cost alternative program requests, including custom drug list reviews, program expansion opportunities, savings analyses, and questions from account management or sales teams.
  • Help document program methodology, operational processes, and workflow updates to support consistent execution and scalable program growth.
  • Lead or support clinical operations responses for Requests for Proposal (RFPs), Requests for Information (RFIs), and other sales-related inquiries, with emphasis on formulary programs and cost-containment solutions.
  • Serve as a clinical operations liaison for ad hoc sales, implementation, account management, and client support requests.
  • Enhance and refine formulary disruption processes for new and existing clients, including review of member and prescriber impact analyses and identification of clinically appropriate alternatives.
  • Support implementation of new formularies as needed, including clinical review and coordination with internal teams.
  • Collaborate with Judi Rx’s Underwriting team to review disruption templates and provide clinical feedback to support accuracy, clarity, and appropriate assumptions.
  • Support standard commercial formulary operations, quality improvement, clinical value, Pharmacy and Therapeutics (P&T), and general Formulary Operations projects, as required.

Required Qualifications

  • Doctor of Pharmacy (PharmD) Degree from an accredited institution, with record of strong academic performance
  • Current, unrestricted registered pharmacist license(s)
  • Residency/fellowship preferred
  • Minimum 1-2 years of pharmacy experience working for a health plan or PBM
  • Understanding of formulary management, claims data analysis, and drug utilization strategies.
  • Experience supporting formulary-related clinical program operations, including workflow design, implementation support, performance monitoring, and ongoing optimization in partnership with cross-functional teams.
  • Excellent communication skills, both written and verbal.
  • Ability to manage multiple complex projects, timelines, and stakeholder requests simultaneously
  • Strong collaboration skills and ability to work effectively across cross-functional teams
  • Ability to evaluate clinical appropriateness of lower-cost medication alternatives and apply formulary strategy considerations.
  • Experience using claims data, reporting outputs, or Excel-based analyses to support operational decision-making preferred.

Preferred Characteristics

  • Detail-oriented and comfortable working through complex clinical, formulary, and claims data questions.
  • Proactive in identifying opportunities to improve programs, streamline workflows, and reduce manual work.
  • Strong clinical judgment with the ability to evaluate lower-cost alternatives while considering member impact, formulary alignment, and operational feasibility.
  • Comfortable partnering with cross-functional teams and explaining clinical or operational recommendations clearly to different audiences.
  • Curious, solution-oriented, and willing to dig into details to understand root causes and develop practical recommendations.
New York, NY Salary Range
$125,000—$135,000 USD
Denver, CO Salary Range
$125,000—$135,000 USD
Charlotte, NC Salary Range
$125,000—$135,000 USD

All employees are responsible for adherence to the Judi Health Code of Conduct including the reporting of non-compliance. 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.

We provide equal employment opportunities to all employees and applicants for employment and prohibit discrimination and harassment of any type without regard to race, color, religion, age, sex, national origin, disability status, medical condition, genetic information, protected veteran status, sexual orientation, gender identity or expression, or any other characteristic protected by federal, state or local laws. 

By submitting an application, you agree to the retention of your personal data for consideration for a future position at Judi Health. More details about Judi Health's privacy practices can be found at https://www.judi.health/legal/privacy-policy.

Skills Required

  • Doctor of Pharmacy (PharmD) degree from an accredited institution
  • Current, unrestricted registered pharmacist license(s)
  • Minimum 1-2 years of pharmacy experience working for a health plan or pharmacy benefit manager (PBM)
  • Understanding of formulary management, claims data analysis, and drug utilization strategies
  • Experience supporting formulary-related clinical program operations, workflow design, implementation support, performance monitoring, and optimization
  • Excellent written and verbal communication skills
  • Ability to manage multiple complex projects, timelines, and stakeholder requests simultaneously
  • Strong cross-functional collaboration skills
  • Ability to evaluate clinical appropriateness of lower-cost medication alternatives and apply formulary strategy considerations
  • Experience using claims data, reporting outputs, or Excel-based analyses for operational decision-making
  • Pharmacy residency or fellowship
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The Company
HQ: New York, NY

What We Do

Judi Health is a health technology company providing a comprehensive suite of solutions for employers and health plans, including: ‍- Capital Rx: a public benefit corporation delivering full-service pharmacy benefit management (PBM) solutions to self-insured employers ‍ - Judi Health™: full-service health benefit management for employers, TPAs, and health plans ‍ - Judi®: a single, scalable SaaS solution that health plans can utilize to manage all their claim workflows Through these solutions, Judi Health is executing on its mission to give our country the infrastructure it needs for the healthcare we deserve. To learn more, visit www.judi.health.

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