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Formulary Operations Pharmacist

Remote

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.

Job Summary:  

We are seeking a detail-oriented and collaborative Formulary Operations Pharmacist to support a wide range of clinical and operational initiatives across Capital Rx. This role will be instrumental in supporting sales efforts and improving formulary disruption processes and workflows.  

Key Responsibilities:  

  • Lead the clinical operations responses process for Requests for Proposal (RFPs), Requests for Information (RFIs), and other sales-related inquiries.  
  • Enhance the formulary disruption process to improve accuracy of member and prescriber impact analyses.  
  • Collaborate with Capital Rx’s Underwriting and Analytics teams to review disruption templates and provide clinical feedback to ensure accuracy and clarity. 
  • Collaborate and enhance and drug mix analytics to further automate process 
  • Support quarterly formulary disruption reviews and assist in identifying clinically appropriate alternatives.  
  • Serve as the clinical operations liaison to assist with ad-hoc sales requests and strategic communications for clients to provide expert insights from a clinical perspective.  
  • Assist in automating formulary alternative recommendations and streamlining related workflows.  
  • Identify opportunities for expansion of the low-cost alternative program, aiming to reduce overall drug spend without compromising care.  
  • Analyze and interpret prescription claims data to identify trends, potential risks, and opportunities for improvement in formulary strategy.  
  • Provide clinical support to operational teams and clients during implementation.  
  • Supports quality improvement and clinical value projects, as required. 
  • Support Pharmacy and Therapeutics (P&T) committee items, as required. 
  • Support general business needs and operations, as required. 
  • Responsible for adherence to the Capital Rx Code of Conduct, including reporting of noncompliance. 

Qualifications:  

  • Doctor of Pharmacy (PharmD) Degree from an accredited institution 
  • Current, unrestricted registered pharmacist license(s) 
  • Residency/fellowship preferred 
  • Minimum 2+ years of pharmacy experience working for a health plan or PBM 
  • Understanding of formulary management, claims data analysis, and drug utilization strategies 
  • Experience working with large datasets required 
  • Proficient in Microsoft Office with strong emphasis on Microsoft Excel and Microsoft PowerPoint 
  • Excellent communication skills, both written and verbal 
  • Ability to balance multiple complex projects simultaneously 
  • Strong collaboration skills and ability to work effectively across cross-functional teams 
  • Creative problem solver with the ability to think outside the box and develop practical, innovative solutions 
  • Extremely flexible, highly organized, and able to shift priorities easily 
  • Attention to detail & commitment to delivering high quality work product 

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. 

Salary Range

$125,000 - $135,000 USD

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.

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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