• Manager of Formulary Management

    Job Location US-MI-Detroit
    Job ID
    Business Line
  • Overview

    Who we are:

    MeridianRx is a full-service Pharmacy Benefit Manager (PBM) committed to driving down costs and elevating quality. Our clients experience better quality outcomes, thanks to effective clinical support, patient education, and specialty pharmacy programs.

    We work with a diverse range of clients, from members to healthcare providers to plan administrators. MeridianRx services clients across the country and our network continues to grow.

    Our employees work hard, play hard, and give back. MeridianRx employees enjoy: Happy hours, special events, company sports teams, potlucks, Bagel Fridays, and volunteer opportunities.


    A Day in the Life of a Manager of Formulary Management:


    This position works under the direction of the Sr. Manager of Operations, and is responsible for overseeing and managing the day-to-day functions of the MeridianRx Formulary Management team. The Manager of Formulary Management coordinates with internal and external stakeholders to implement, monitor and oversee formulary enhancements that promote clinically sound and financially driven formularies. The Manager of Formulary Management ensures all formulary analyses are created and submitted at the request of any MeridianRx Client and changes are pursuant to guidelines set for by client contracts, State and Federal regulations.


    • Directly manage assigned staff which includes hiring, scheduling, monitoring workload, conducting performance evaluations and implementing disciplinary action, when necessary
    • Provide clinical and pharmacoeconomic formulary recommendations to the MeridianRx Pharmacy and Therapeutics Committee that support safe, efficacious, and cost-effective prescribing and drug use
    • Maintain, facilitate access to, and distribute clinical formulary information, recommendations for formulary drug positioning, and revision of utilization management in collaboration with clinical operations and the Medical Director
    • Provide direct client clinical consultation relative to formulary management and ensure all State and Federal guidelines are met
    • Ensure the review, coding and quality control of formulary changes occur in an accurate and timely manner
    • Track, monitor, and analyze formulary management reports to regularly assess implementation of formulary and policy decisions
    • Oversee and monitor all aspects of MeridianRx formulary operations including developing and implementing the appropriate monitoring mechanisms necessary for evaluating operational performance
    • Track, monitor and analyze formulary management reports to regularly assess implementation of formulary and policy decisions
    • Coordinate information from drug manufacturers related to P&T reviews, including manufacturer incentives and rebate programs
    • Ensure all aspects of the Medicare formulary submission process are completed timely and accurately
    • Respond to day-to-day business issues with subject matter expertise
    • Provide Medicare Part D subject matter expertise, with a focus on Formulary Administration (FA), to internal staff and external Medicare clients
    • Maintain awareness of trends, developments and governmental regulations in Medicare and managed healthcare organizations
    • Oversee the aggregation and submission of Part D annual formulary reports for internal/external clients
    • Provide operational support, relative to the Pharmacy Benefit Manager (PBM) formulary functions, to the State Directors of Operations when requested
    • Partner with the Medicare Compliance team to improve high-risk audit area performance and to scale existing operations for future business endeavors


    What you can bring to MeridianRx:

    • Bachelor’s degree in Business, Healthcare of a related field is required
    • PharmD or graduate degree is required
    • Residency and/or Board Certification is preferred.
    • At least three years of experience in managed health care or pharmacy programs is required.
    • Previous experience in Medicare and/or Medicaid programs is required.
    • Extensive experience and professional training likely to include industry certifications or advanced degrees are preferred.
    • Knowledge of Medicare Part D requirements and HPMS submission processes is preferred
    • Expertise in clinical program components, formulary designs, and prescription drug benefit trends is required
    • Demonstrated adaptability and flexibility to changes and response to new ideas and approaches is required

    What MeridianRx can offer you:

    • Healthcare benefits that include a variety of plans, which are effective on the first day of employment for our new full-time team members.
    • Opportunity to work with the industry’s leading technologies and participate in unique projects, demonstrations, conferences, and exclusive learning opportunities.
    • 401k matching that is above the national average.
    • Full-time MeridianRx employees are eligible for tuition reimbursement towards Bachelor’s or graduate degrees.
    • A bright and engaging company culture; the Meridian family of companies has been recognized as one of Metro Detroit’s Best and Brightest Companies to Work For 5 years in a row.


    Equal Opportunity Employer



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