Job Title: Associate Director – Formulary Operations
Company Overview:
Pulivarthi Group is a premier global provider of staffing and IT technology solutions, renowned for delivering exceptional services tailored to each client's unique needs. With a steadfast commitment to excellence, we merge expertise with innovation, ensuring cost-effective solutions of the highest quality. Our diverse client base spans healthcare, finance, government, and beyond, reflecting our adaptability and proficiency across industries. Operating in the United States, Canada, and Mexico, we pride ourselves on aligning with clients' cultures, deploying top-tier talent, and utilizing cutting-edge technologies. Pulivarthi Group stands as a beacon of reliability, efficiency, and innovation in the realm of staffing solutions.
Job Overview/Summary:
We are seeking an experienced Associate Director – Formulary Operations to lead the development, implementation, and maintenance of custom formularies across multiple lines of business, including Commercial, Medicaid, and Health Information Marketplace/Exchange plans. This role will oversee formulary strategies, regulatory compliance, cross-functional team leadership, and vendor relationships to ensure operational excellence and superior client service.
Responsibilities:
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Oversee development and maintenance of custom formularies for all non-Medicare lines of business.
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Monitor and analyze regulatory and legislative requirements; develop and execute project plans to meet requirements.
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Lead cross-functional teams to implement new programs and maintain compliance with evolving regulations.
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Support relationships with external partners/vendors, including P&T committees, rebate aggregators, and formulary management tool providers.
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Communicate clinical issues and objectives to clients, members, and internal teams; develop education materials as needed.
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Supervise and coach direct reports, conducting performance reviews and providing regular feedback.
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Develop clinical criteria for review of non-formulary or non-preferred drug lists; communicate recommendations to clients.
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Evaluate drugs/drug classes to recommend formulary positioning, utilization management, and formulary management strategies.
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Provide operational support during implementation of formulary programs.
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Analyze and interpret prescription claims data to identify opportunities for improved formulary management strategies.
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Support quality improvement and clinical value projects as needed.
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Support P&T committee items, RFI/RFP submissions, and other business needs as required.
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Ensure adherence to the organization’s Code of Conduct, including reporting of noncompliance.
Primary Skills:
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Expertise in formulary development, maintenance, and strategy across Commercial and Medicaid lines of business.
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Knowledge of highly managed specialty medications and formulary management tools.
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Strong ability to analyze prescription claims data to drive strategy.
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Excellent leadership, communication, and cross-functional collaboration skills.
Secondary Skills (Good to Have):
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Residency or fellowship training.
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Experience managing external vendors and rebate aggregators.
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Strong Microsoft Excel and PowerPoint proficiency.
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Experience working with large datasets.
Qualifications:
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Doctor of Pharmacy (PharmD) from an accredited institution with a record of strong academic performance.
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Current, unrestricted registered pharmacist license(s).
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6–8 years of pharmacy experience working for a health plan or PBM (residency/fellowship preferred).
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Proficiency in Microsoft Office Suite (Excel and PowerPoint emphasized).
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Ability to manage multiple complex projects simultaneously.
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Exceptional written and verbal communication skills.
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Flexible, highly organized, and able to shift priorities easily.
What We Offer:
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Opportunity to work in a dynamic, growing organization.
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Comprehensive benefits package.
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Exposure to high-impact projects across multiple lines of business.
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A values-driven organization that prioritizes:
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Integrity First: Doing the right thing.
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Results: Delivering measurable outcomes.
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Additional Requirements:
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Candidates must be able to provide proof of eligibility to work in the United States.
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Background check and drug screening may be required based on position requirements.
Equal Opportunity Statement:
Pulivarthi Group is proud to be an equal opportunity employer. We are committed to building a diverse and inclusive culture and celebrate authenticity. We do not discriminate on the basis of race, religion, color, national origin, gender, gender identity, sexual orientation, age, marital status, disability, protected veteran status, or any other legally protected characteristics.