Formulary Operations Pharmacist

Judi Health

$125K — $135K *
Healthcare
Less than 5 years of experience
Job Overview by Ladders

Qualifications

  • Doctor of Pharmacy (PharmD) Degree from an accredited institution with strong academic performance.
  • Current, unrestricted registered pharmacist license(s).
  • 1-2 years of pharmacy experience in a health plan or PBM.
  • Understanding of formulary management, claims data analysis, and drug utilization strategies.
  • Experience in supporting formulary-related clinical program operations and cross-functional teamwork.

Responsibilities

  • Manage and optimize the low-cost alternative program and its associated drug lists.
  • Identify lower-cost medication alternatives for high-cost drugs to reduce spending.
  • Analyze claims data for program performance and support dashboard creation.
  • Collaborate with internal teams to enhance program workflows and reporting.
  • Document operational processes to ensure consistent execution and scalability.
  • Lead clinical responses for RFPs, RFIs, and other sales inquiries regarding formulary solutions.
  • Refine formulary disruption processes, including member and prescriber impact assessments.

Benefits

  • Hybrid work model with flexibility in work location.
  • Opportunity to work collaboratively across multiple teams in a forward-thinking environment.
  • Engagement in innovative programs focused on clinical outcomes and cost savings.
  • Support for ongoing professional development and career advancement.
Full Job Description
Location: Hybrid (Local to Charlotte, NC; Denver, CO; or New York, NY area)

Position Overview

We are seeking a detail-oriented and collaborative Formulary Operations Pharmacist to support clinical and operational initiatives across Judi Rx, with a primary focus on the low-cost alternative program. This role will help maintain and expand clinically appropriate low-cost alternative opportunities, support program reporting and performance tracking, and partner cross-functionally to improve workflows that drive savings for members and plan sponsors. The pharmacist will also continue to support formulary disruption, implementation of new formularies, standard commercial formulary operations, sales-related requests, and other Formulary Operations priorities as needed.

Key Responsibilities
  • Support day-to-day management and ongoing optimization of the low-cost alternative program, including maintenance of target drug and alternative lists.
  • Evaluate high-cost medications and identify clinically appropriate, formulary-aligned lower-cost alternatives that may reduce spend for members and plan sponsors.
  • Analyze claims data, test claim results, opportunity volume, savings outputs, and intervention results to monitor program performance, identify trends, and support dashboard creation and maintenance for the low-cost alternative program and other formulary-focused initiatives.
  • Partner with Product, Analytics, Clinical Programs, Benefits, and other internal teams to improve low-cost alternative program logic, implementation workflows, reporting, and member/prescriber engagement processes.
  • Support client-specific low-cost alternative program requests, including custom drug list reviews, program expansion opportunities, savings analyses, and questions from account management or sales teams.
  • Help document program methodology, operational processes, and workflow updates to support consistent execution and scalable program growth.
  • Lead or support clinical operations responses for Requests for Proposal (RFPs), Requests for Information (RFIs), and other sales-related inquiries, with emphasis on formulary programs and cost-containment solutions.
  • Serve as a clinical operations liaison for ad hoc sales, implementation, account management, and client support requests.
  • Enhance and refine formulary disruption processes for new and existing clients, including review of member and prescriber impact analyses and identification of clinically appropriate alternatives.
  • Support implementation of new formularies as needed, including clinical review and coordination with internal teams.
  • Collaborate with Judi Rx's Underwriting team to review disruption templates and provide clinical feedback to support accuracy, clarity, and appropriate assumptions.
  • Support standard commercial formulary operations, quality improvement, clinical value, Pharmacy and Therapeutics (P&T), and general Formulary Operations projects, as required.


Required Qualifications
  • Doctor of Pharmacy (PharmD) Degree from an accredited institution, with record of strong academic performance
  • Current, unrestricted registered pharmacist license(s)
  • Residency/fellowship preferred
  • Minimum 1-2 years of pharmacy experience working for a health plan or PBM
  • Understanding of formulary management, claims data analysis, and drug utilization strategies.
  • Experience supporting formulary-related clinical program operations, including workflow design, implementation support, performance monitoring, and ongoing optimization in partnership with cross-functional teams.
  • Excellent communication skills, both written and verbal.
  • Ability to manage multiple complex projects, timelines, and stakeholder requests simultaneously
  • Strong collaboration skills and ability to work effectively across cross-functional teams
  • Ability to evaluate clinical appropriateness of lower-cost medication alternatives and apply formulary strategy considerations.
  • Experience using claims data, reporting outputs, or Excel-based analyses to support operational decision-making preferred.

Preferred Characteristics
  • Detail-oriented and comfortable working through complex clinical, formulary, and claims data questions.
  • Proactive in identifying opportunities to improve programs, streamline workflows, and reduce manual work.
  • Strong clinical judgment with the ability to evaluate lower-cost alternatives while considering member impact, formulary alignment, and operational feasibility.
  • Comfortable partnering with cross-functional teams and explaining clinical or operational recommendations clearly to different audiences.
  • Curious, solution-oriented, and willing to dig into details to understand root causes and develop practical recommendations.


New York, NY Salary Range

$125,000-$135,000 USD

Denver, CO Salary Range

$125,000-$135,000 USD

Charlotte, NC Salary Range

$125,000-$135,000 USD

All employees are responsible for adherence to the Judi Health Code of Conduct including the reporting of non-compliance. This position description is designed to be flexible, allowing management the opportunity to assign or reassign duties and responsibilities as needed to best meet organizational goals.

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