Location: Remote (For Non-Local) or Hybrid (Local to NYC area)

About Capital Rx

Capital Rx is a next generation pharmacy benefits manager, overseeing prescription benefit plans on behalf of employers, unions, and government entities. Determined to transform an outdated model, Capital Rx’s mission is to change the way prescription benefits are priced and administered in the US, unlocking enduring social change. Through our platform approach, Capital Rx delivers data-driven insights and actionable strategies that reduce costs, while improving patient outcomes. Our commitment to innovation, technology and service is the reason why Capital Rx is among the fastest-growing PBMs in the country.

Position Responsibilities:

• Responsible for developing Capital Rx’s autonomous pharmacy and therapeutics functions
• Evaluates drug and drug class reviews based on sound evidence-based literature and standards of care
• Creates strategy recommendations regarding drugs, classes, and utilization management edits/criteria across clients and all lines of business
• Collaborates with cross-functional partners to identify new opportunities through optimization of new and existing formulary solutions to meet market needs
• Participates in internal and/or external meetings to support and present relevant information as needed
• Updates and maintain the teams SOPs, procedures, and checklists to ensure requirements are met for URAC, NCQA, and other state licensure/accreditation agencies
• Contributes and actively participate in Capital Rx’s clinical and/or financial committee meetings that manage drug review
• Supports general business or team needs, as assigned

Required Qualifications:

• PharmD from an accredited institution, required
• PGY1/PGY2 Managed Care pharmacy residency, preferred
• 5 years of PBM/health plan experience in formulary management/strategy across all LOBs, preferred
• Clinical knowledge of multiple therapeutic categories for manufacturer assignments (e.g. CV, Diabetes, Respiratory disease)
• An understanding and knowledge of established clinical guidelines
• Previous Pharmacy and Therapeutics Committee experience and familiarity with requirements highly preferred
• Ability to balance multiple complex projects simultaneously
• Exceptional written and verbal communication skills
• Extremely flexible, highly organized, and able to shift priorities easily
• High attention to detail and a self-starter
• Commitment to delivering high quality work product

Base Salary: $130,000 - $170,000

This range represents the low and high end of the anticipated base salary range for the NY - based position. The actual base salary will depend on several factors such as: experience, knowledge, and skills, and if the location of the job changes.

Capital Rx values a diverse workplace and celebrates the diversity that each employee brings to the table. We are proud to provide equal employment opportunities to all employees and applicants for employment and prohibit discrimination and harassment of any type without regard to race, color, religion, age, sex, national origin, disability status, medical condition, genetic information, protected veteran status, sexual orientation, gender identity or expression, or any other characteristic.