Specialist, Formulary Operations

🕒 vor 1 Tag

🥔 Idaho – Remote

info

💵 $20 - $23 / Stunde

⏰ Vollzeit

🟡 Mittelstufe

🟠 Senior

⚙️ Operations

🗣️🇺🇸🇬🇧 Englisch erforderlich

Jetzt Bewerben
Ähnliche Remote-Jobs finden

📊 Überprüfen Sie Ihre Lebenslauf-Bewertung für diese Stelle

Verbessern Sie Ihre Chancen auf ein Vorstellungsgespräch, indem Sie Ihre Lebenslauf-Bewertung vor der Bewerbung überprüfen.

Logo of Navitus Health Solutions

Navitus Health Solutions

1001 - 5000 Mitarbeiter

Gegründet 2003

⚕️ Krankenversicherung

💊 Pharmazie

🤝 B2B

Healthcare Insurance • Pharmaceuticals • B2B

Navitus Health Solutions ist ein Anbieter von Apothekenmanagement-Dienstleistungen (Pharmacy Benefit Manager, PBM), der transparente, menschenzentrierte Lösungen für Gesundheitspläne, Arbeitgeber, Regierungsprogramme und andere Plan-Anbieter bereitstellt. Das Unternehmen betreibt ein 100%iges Durchleitungsmodell mit Kostenaufschlag, das darauf abzielt, Medikamentenkosten zu senken, Formulare zu verwalten, Spezialmedikamente zu managen (einschließlich einer Kosten-plus-Spezialapotheke), die Abwicklung von Leistungsansprüchen, Apothekennetzwerk-Management sowie die Unterstützung und Aktivierung von Mitgliedern zu gewährleisten. Navitus positioniert sich als treuhänderischer Partner mit Fokus auf Bezahlbarkeit, Compliance, klinische Qualität und die Verbesserung von Gesundheitsergebnissen durch maßgeschneiderte PBM-Dienstleistungen und digitale Gesundheitsintegrationen.

Beschreibung

• Perform the daily, weekly, and monthly/periodic administrative functions necessary to update and maintain the formularies for Navitus’ clients for all lines of business • Work with the Formulary Services Supervisors to make all changes to the formulary information accessed by clients • Day to day formulary maintenance • Having advisory input to how this information is presented, maintained, and reviewed • 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

🎯 Anforderungen

• 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.

🏖️ Vorteile

• Top of the industry benefits for Health, Dental, and Vision insurance • 20 days paid time off • 4 weeks paid parental leave • 9 paid holidays • 401K company match of up to 5% - No vesting requirement • Adoption Assistance Program • Flexible Spending Account • Educational Assistance Plan and Professional Membership assistance • Referral Bonus Program – up to $750!

Jetzt Bewerben

Ähnliche Jobs

🕒 vor 1 Tag

Kobie

201 - 500

Operations Manager supporting the efficiency of a technical operations team at Kobie, a loyalty solutions provider. Collaborating with clients and internal teams to optimize program delivery.

🇺🇸 Vereinigte Staaten – Remote

⏰ Vollzeit

🟡 Mittelstufe

🟠 Senior

⚙️ Operations

🗣️🇺🇸🇬🇧 Englisch erforderlich

🕒 vor 1 Tag

The Disruptors Den

51 - 200

🤝 B2B

🌍 Soziale Wirkung

Operations Coordinator providing administrative and coordination support in the COO's office at ALX Africa, a company dedicated to unlocking Africa’s digital future through tech skills training and career acceleration.

🇺🇸 Vereinigte Staaten – Remote

⏰ Vollzeit

🟢 Junior

🟡 Mittelstufe

⚙️ Operations

🗣️🇺🇸🇬🇧 Englisch erforderlich

🕒 vor 1 Tag

Center for Health Care Strategies

51 - 200

⚕️ Krankenversicherung

🤝 Non-Profit

🌍 Soziale Wirkung

Compensation Manager responsible for compensation programs ensuring competitive pay practices at Nemours Children’s Health. Leading strategy execution alongside HR leadership and external vendors.

🇺🇸 Vereinigte Staaten – Remote

⏰ Vollzeit

🟠 Senior

🔴 Experte

⚙️ Operations

🗣️🇺🇸🇬🇧 Englisch erforderlich

🕒 vor 1 Tag

Switzerland Global Enterprise

51 - 200

🤝 B2B

🛍️ eCommerce

CPQ Functional Lead responsible for defining strategic direction and roadmap for the CPQ platform supporting HD Gas Power Services business. Collaborating with teams to enhance platform adoption and efficiency.

🇺🇸 Vereinigte Staaten – Remote

💵 $128.400 - $213.900 / Jahr

⏰ Vollzeit

🟠 Senior

⚙️ Operations

🗣️🇺🇸🇬🇧 Englisch erforderlich

🕒 vor 1 Tag

Switzerland Global Enterprise

51 - 200

🤝 B2B

🛍️ eCommerce

NEX Functional Lead defining strategic CRM direction for HD Gas Power Services business. Partnering with leaders to enhance platform for growth and user experience.

🇺🇸 Vereinigte Staaten – Remote

💵 $128.400 - $213.900 / Jahr

⏰ Vollzeit

🟠 Senior

⚙️ Operations

🗣️🇺🇸🇬🇧 Englisch erforderlich