Putting People First in Pharmacy- Navitus was founded as an alternative to traditional pharmacy benefit manager (PBM) models. We are committed to removing cost from the drug supply chain to make medications more affordable for the people who need them. At Navitus, our team members work in an environment that celebrates diversity, fosters creativity and encourages growth. We welcome new ideas and share a passion for excellent service to our customers and each other.
We are unable to offer remote work to residents of Alaska, Hawaii, Maine, Mississippi, New Hampshire, New Mexico, North Dakota, Rhode Island, South Carolina, South Dakota, West Virginia, and Wyoming.
The Specialist, Formulary Operations will perform the daily, weekly, and monthly/periodic administrative functions necessary to update and maintain the formularies for Navitus’ clients for all lines of business. This includes working with the Formulary Services Supervisors to make all changes to the formulary information accessed by clients, as well as day to day formulary maintenance; and 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.
- Maintain open lines of communication with other functional areas/departments
- Maintain an environment of collaboration and cooperation with coworkers
- Be an effective ambassador of Navitus’ vision, mission, values, goals and policies
- Participate in meetings and committees as requested/assigned
- Approximate travel required (5-10%).
- Other related duties as assigned/required.
Essential Background Requirements:
- Education: 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.
- Critical thinking/Problem-solving
- Judgment and Decision-making
- Communication Skills (written, verbal/presentation and active listening)
- Customer-Centric Skills and the ability to understand internal and external customers
- Strategic Thinking/Systems Aptitude Thinking
- Ability to prioritize continually/multi-task
- Understanding and coping with constant change
- Ability to build and manage relationships
- Ability to learn about present and future projects and programs as the work evolves
- Ability to analyze the current systems, recognize areas of improvement, and work with others to introduce change
- Ability to identify errors and their sources and to pool resources to make the necessary corrections and improvements to the system without placing blame
- The ability to consistently interact cooperatively and respectfully with other employees
- Participate in, adhere to, and support compliance program objectives.