Medicare Formulary Operations Pharmacist (Hybrid)

Capital Rx; Denver (CO); Hybrid; USD 125,000 - 135,000; Full time

Job summary

Judi Health is seeking a Formulary Operations Pharmacist - Medicare to support Medicare Part D formulary evaluation, implementation, and maintenance, and to assist with CMS files and member drug lists. The role requires cross-functional communication and strong knowledge of CMS rules.

Hybrid work options include Denver, CO. The position involves maintaining standard and custom formularies, preparing monthly CMS submissions, and expanding scope to non-Medicare lines as needed, with a strong

Qualifications

• : Doctor of Pharmacy (PharmD) Degree from an accredited institution
• : Current, unrestricted registered pharmacist license(s)
• : Residency/fellowship preferred
• : 2+ years of Medicare formulary experience with a health plan or PBM
• : Knowledge of CMS guidelines and formulary development processes
• : Proficient in Microsoft Office with strong emphasis on Excel

Responsibilities

• Maintain Medicare formularies per CMS guidelines
• Prepare CMS formulary submissions and look-up tools
• Collaborate across functions to drive operational excellence
• Evaluate drugs and drug classes for formulary positioning
• Support non-Medicare formulary management tasks as needed
• Provide clinical support to operations and clients during implementations
• Lead testing of client formulary and benefit elections
• Identify automation opportunities with Analytics team
• Ensure regulatory reporting to State and Federal regulators

Skills

Communication skills

Attention to detail

Microsoft Excel

Project management

Flexibility

Education

PharmD degree

Licensed pharmacist

Residency/fellowship preferred

Tools

Microsoft Excel

Job description

Judi Health is seeking a Formulary Operations Pharmacist - Medicare to support Medicare Part D formulary evaluation, implementation, and maintenance, and to assist with CMS files and member drug lists. The role requires cross-functional communication and strong knowledge of CMS rules.

Hybrid work options include Denver, CO. The position involves maintaining standard and custom formularies, preparing monthly CMS submissions, and expanding scope to non-Medicare lines as needed, with a strong