SmithRx is a tech-forward PBM committed to changing the way pharmacy benefits are managed.

Formulary Operations Specialist

OperationsOperationsFull TimeRemoteTeam 51-200Since 2018H1B No SponsorCompany Site LinkedIn

Location

United States

Posted

3 days ago

Salary

Not specified

Bachelor Degree2 yrs expEnglish

Job Description

• Execute complex formulary coding within adjudication systems, ensuring clinical intent is accurately reflected in system logic. • Utilize Advanced Excel and Google Sheets (VLOOKUP, Index/Match, Pivot Tables, and complex nested formulas) to manipulate large datasets. • Apply deep knowledge of PBM hierarchies and adjudication logic to troubleshoot rejected claims and optimize system performance. • Manage multiple high-priority projects simultaneously, shifting priorities fluidly to meet urgent client needs or business deadlines.

Job Requirements

Minimum of 2 years of direct experience in a PBM or Managed Care environment.
Having an active Pharmacy Technician license or registration is highly preferred.
Expert-level capability in Excel and Google Sheets, specifically for data cleaning, transformation, and complex formula building.
Proven experience in formulary management systems and a strong grasp of adjudication coding and hierarchy structures.
Deep knowledge of Medispan drug information or similar drug database platforms.
Analytical Thinking: Exceptional critical thinking skills and the ability to solve complex problems independently.
Detail Orientation: Meticulous attention to detail when managing high-stakes data updates.
Adaptability: The ability to thrive and remain composed in a demanding, constantly evolving landscape.
Project Management: Strong organizational skills with the ability to manage timelines and prioritize tasks according to business and client urgency.
Systems Thinking Mindset: The ability to look beyond the immediate task to understand how system updates ripple through the entire system.

Benefits

Highly competitive wellness benefits including Medical, Pharmacy, Dental, Vision, and Life Insurance and AD&D Insurance
Flexible Spending Benefits
401(k) Retirement Savings Program
Short-term and long-term disability
Discretionary Paid Time Off
Paid Company Holidays
Wellness Benefits
Commuter Benefits
Paid Parental Leave benefits
Employee Assistance Program (EAP)
Well-stocked kitchen in office locations
Professional development and training opportunities