Specialist II, Formulary Operations

Navitus Health Solutions

. Operationalize formulary information from various sources including FAC, P&T, Medispan and CAEs to coordinate the process of getting the information into the Formulary and Benefit Management System (FBMS) and then communicated to Benefits Systems and Auditing .

Posted 5/1/2026full-timeRemote • Alaska, Hawaii, Maine, Mississippi, New Hampshire, New Mexico, North Dakota, Rhode Island, South Carolina, South Dakota, Virginia, West Virginia, Wyoming • 🇺🇸 United StatesMid-LevelSenior💰 $22 - $26 per hourWebsite

About the role

Key responsibilities & impact

Operationalize formulary information from various sources including FAC, P&T, Medispan and CAEs to coordinate the process of getting the information into the Formulary and Benefit Management System (FBMS) and then communicated to Benefits Systems and Auditing
Coordinate implementation schedule of new clients
Work with implementation team to streamline process for new client implementations
Coordinate creating and building of unique formulary designs for custom clients
Make independent decisions on formulary setup and maintenance when creating and building new formulary designs for custom clients which directly affects the bottom line of our clients
Coordinate formulary document creation and posting, including maintenance of web, e-prescribing, formularies, change notifications, and medication program lists
Trouble-shoot various formulary/set-up questions
Review weekly Medispan Reports for specific changes that would affect the formulary
Approximate travel required (5-10%)
Other duties as assigned

Requirements

What you’ll need

A minimum of a High School diploma plus specialized knowledge relating to pharmacy practice and business software applications is required
CPhT certification and experience as a pharmacy technician is required
2-5 years’ experience working with formulary information; proven analytical, problem solving and written and verbal communication skills
Experience in PBM / Managed health care claims processing strongly preferred
Proficient in Word and Excel
Must be comfortable communicating with vendors, outside and internal customers
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 from community practice)
Experience with maintenance of formulary setup and documents
Participate in, adhere to, and support compliance program objectives
The ability to consistently interact cooperatively and respectfully with other employees

Benefits

Comp & perks

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!

ATS Keywords

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Applicant Tracking System Keywords

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Hard Skills & Tools

formulary informationclaims processingformulary setupformulary document creationanalytical skillsproblem solvingwritten communicationverbal communicationpharmacy practicedrug names

Soft Skills

independent decision makingstreamlining processescooperative interactionrespectful communication

Certifications

CPhT certification