Formulary Administration Specialist

MedImpact • San Diego, CA

13h • Onsite

About The Position

The Formulary Administration Specialist I participates in the design and validation of pharmacy benefit management plans. The position ensures accurate coding of plan-specific information into formulary systems and provides comprehensive support to external clients related to formulary change requests. It helps maintain service levels that meet corporate performance and quality standards. The role supports drug updates for commercial clients, formulary mailbox and client platform inquiries, negative formulary changes, and formulary processes. The specialist develops knowledge of formulary and PBM operations through on-the-job training, internal educational opportunities, and external seminars or coursework. This is an internal- and external-client-facing role requiring strong customer service and interpersonal communication. The position is on-site at MedImpact's San Diego Headquarters or another company location, with remote work possible with management approval based on business requirements. Domestic travel may be required up to 5% of the time. Typical core business hours are Monday through Friday, 8:00 a.m. to 5:00 p.m.; the role may require work beyond traditional hours, including nights, weekends, or holidays, to meet responsibilities and deadlines. The position is exempt and is not eligible for sponsorship.

Requirements

• Associate’s degree and at least 2 years of experience, or an equivalent combination of education and experience.
• Current Pharmacy Technician License and/or unrestricted CPhT certification.
• Good working knowledge of Microsoft Office Suite, including Word, Excel, and Outlook.
• Good familiarity working with databases.
• Basic PBM knowledge.
• Drug Information and Prior Authorization experience preferred by the posting, but listed under Other Skills and Abilities.
• Good written and verbal communication skills and interpersonal skills.
• Ability to work cohesively with a team, juggle multiple priorities, follow tasks through to completion, and remain detail-oriented.
• Ability to interpret instructions in written, oral, diagram, or schedule form.
• Ability to perform basic arithmetic and compute rates, ratios, and percentages, and to draw and interpret bar graphs.
• Ability to present information effectively in one-on-one and small-group situations, write routine reports and correspondence, and speak effectively before groups.
• Ability to meet the physical demands of the role, including sitting, talking or hearing, standing, walking, using hands to handle objects, reaching, occasionally lifting or moving up to 25 pounds, and maintaining close vision, adequate color vision, and depth perception.
• Must be able to work the hours required to accomplish responsibilities and meet deadlines, with flexibility to work beyond traditional hours, including nights, weekends, or holidays as required.
• Must provide adequate support to internal clients and be available for regular interactions and coordination with employees, colleagues, clients, or vendors, and for collaboration with stakeholders.

Nice To Haves

• Familiarity with National Drug Data Provider products.
• Medicare Part D formulary knowledge.

Responsibilities

• Review weekly, monthly, and quarterly drug update projects for commercial clients.
• Prepare weekly, monthly, and quarterly formulary files for pharmacist review.
• Monitor and update Drug Rules and Auto-Coding rules.
• Research and respond to client inquiries, escalating complex issues to managers or pharmacists.
• Triage formulary mailbox and client-platform inquiries, troubleshoot basic issues, and escalate complex matters to managers or pharmacists.
• Draft client communications for management review and customize templates with client instructions, including clarification of roles and responsibilities between MedImpact and the client.
• Prepare routine responses to client email and case queries.
• Compile member disruption reports for pharmacist review as part of the negative formulary changes process.
• Review member letters before distribution.
• Build formulary shells with pharmacists.
• Provide claims analysis support.
• Develop understanding of formulary and PBM operations through on-the-job training, internal educational opportunities, and related external seminars or coursework.
• Meet client service commitments, respond promptly to client needs, solicit feedback to improve service, and assist with service requests.
• Perform other duties as assigned.

Benefits

• Medical, dental, and vision coverage.
• Wellness programs.
• Paid time off and company-paid holidays.
• Incentive compensation.
• 401(k) with company match.
• Life and disability insurance.
• Tuition reimbursement.
• Employee referral bonus.

What This Job Offers

• Job Type: Full-time
• Career Level: Entry Level
• Education Level: Associate degree