Formulary Operations Specialist

Who We Are:

SmithRx is a rapidly growing, venture-backed Health-Tech company.  Our mission is to disrupt the expensive and inefficient Pharmacy Benefit Management (PBM) sector by building a next-generation drug acquisition platform driven by cutting edge technology, innovative cost saving tools, and best-in-class customer service.  With hundreds of thousands of members onboarded since 2016, SmithRx has a solution that is resonating with clients all across the country.

We pride ourselves for our mission-driven and collaborative culture that inspires our employees to do their best work. We believe that the U.S healthcare system is in need of transformation, and we come to work each day dedicated to making that change a reality. At our core, we are guided by our company values:

• Integrity: Our purpose guides our actions and gives us confidence in the path ahead. With unwavering honesty and dependability, we embrace the pressure of challenging the old and exemplify ethical leadership to create the new.
• Courage: We face continuous challenges with grit and resilience. We embrace the discomfort of the unknown by balancing autonomy with empathy, and ownership with vulnerability. We boldly challenge the status quo to keep moving forward—always.
• Together: The success of SmithRx reflects the strength of our partnerships and the commitment of our team. Our shared values bind us together and make us one. When one falls, we all fall; when one rises, we all rise.

Job Summary:

The Formulary Operations Specialist is responsible for the technical configuration, maintenance, and quality assurance of drug formularies within our adjudication systems. As a primary steward of data accuracy across multiple platforms, you will ensure information remains synchronized and reliable to support seamless functionality across the entire organization. You will leverage advanced data manipulation skills to translate clinical strategies into flawless operational execution.

What you will do:

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

What you will bring to SmithRx:

• Minimum of 2 years of direct experience in a PBM or Managed Care environment.
• 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.

What SmithRx Offers You: 

• 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