Formulary Analyst (Internal Only)

MotivHealth Insurance Company • South Jordan, UT

1d

About The Position

MotivHealth is seeking a detail-oriented Formulary Analyst to support the development, maintenance, and administration of pharmacy formularies for our health plans. This role plays a key part in ensuring formulary accuracy, cost-effectiveness, and compliance, while supporting plan sponsors, members, and internal teams with pharmacy benefit design.

Requirements

• 2 + years of experience in formulary management, pharmacy benefits, or PBM operations
• Familiarity with pharmacy claims systems and formulary management tools
• Strong understanding of drug classifications, tiering structures, and utilization management criteria
• Excellent analytical skills with the ability to interpret pharmacy utilization and pricing data
• Strong communication skills, with the ability to explain formulary decisions to both technical and non-technical stakeholders
• Detail-oriented with strong organizational and documentation skills

Responsibilities

• Build, maintain, and update pharmacy formularies in alignment with plan design and client specifications
• Analyze drug utilization trends, pricing, and rebate data to support formulary decision-making
• Collaborate with PBMs (Pharmacy Benefit Managers) to ensure accurate formulary loading and claims adjudication
• Review and process prior authorization, step therapy, and quantity limit criteria within formulary structures
• Monitor drug pipeline updates, new FDA approvals, and generic/biosimilar releases to recommend formulary changes
• Partner with underwriting, account management, and client services teams to communicate formulary structures and plan-specific pharmacy benefits
• Ensure formulary compliance with ACA, ERISA, and other applicable regulatory requirements
• Assist in resolving member and provider inquiries related to formulary coverage and exceptions
• Maintain accurate documentation of formulary changes, rationale, and version history

What This Job Offers

• Job Type: Full-time
• Career Level: Mid Level
• Education Level: No Education Listed