Associate Director, Formulary Operations

Location: Remote or Hybrid (Local to NYC or Denver area)

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

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

Base salary: $150,000-160,000

All employees are responsible for adherence to the Capital Rx Code of Conduct including reporting of noncompliance.

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.

About Capital Rx

Capital Rx is a health technology company providing claim administration and technology solutions for carriers, health plans, TPAs, employer groups, and government entities. As a public benefit corporation, Capital Rx is executing its mission to materially reduce healthcare costs as a full-service PBM and through the deployment of Judi, the company's cloud-native enterprise health platform. Judi connects every aspect of the healthcare ecosystem in one efficient, scalable platform, servicing millions of members for Medicare, Medicaid, and commercial plans. Together with its clients, Capital Rx is reimagining the administration of benefits and rebuilding trust in healthcare.

Capital Rx values a diverse workplace and celebrates the diversity that each employee brings to the table. We are proud to 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.

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