Specialist, Formulary Operations

🕒 il y a 8 jours

🥔 Idaho – Distant

🥔 Idaho – Remote

💵 $20 - $23 / heure

⏰ Temps Plein

🟡 Intermédiaire

🟠 Senior

⚙️ Opérations

Postuler Maintenant

Trouver des Emplois à Distance Similaires

Recevoir des emails pour des emplois à distance

📊 Vérifiez votre score de CV pour ce poste

Améliorez vos chances d'obtenir un entretien en vérifiant votre score de CV avant de postuler.

Télécharger le CV

Navitus Health Solutions

Site WebLinkedInTous les Emplois

1001 - 5000 employés

Fondée en 2003

⚕️ Assurance santé

💊 Pharmaceutique

🤝 B2B

Healthcare Insurance • Pharmaceuticals • B2B

Navitus Health Solutions est un gestionnaire de prestations pharmaceutiques (PBM) qui propose des solutions transparentes et centrées sur les personnes pour les prestations pharmaceutiques, à destination des régimes de santé, des employeurs, des programmes gouvernementaux et d'autres parrains de régimes. L'entreprise opère sur un modèle de passage intégral à un coût majoré, qui met l'accent sur la réduction des coûts des médicaments, la gestion des formulaires, la gestion des médicaments spécialisés (y compris une pharmacie spécialisée à coût majoré), l'évaluation des réclamations, la gestion du réseau de pharmacies, ainsi que l'activation et le support des membres. Navitus se positionne comme un partenaire fiduciaire axé sur l'accessibilité, la conformité, la qualité clinique, et l'amélioration des résultats de santé grâce à des services PBM sur mesure et à des intégrations de santé numérique.

Description

• 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

🎯 Exigences

• 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.

🏖️ Avantages

• 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!