Pharmacy Specialist

About the role

Quartz is seeking Pharmacy Specialists to support our government program operations and formulary support teams within our pharmacy management department. Two positions are available: Pharmacy Specialist, Government Program Operations and Pharmacy Specialist, Formulary Support.

Responsibilities

• Pharmacy Specialist, Government Program Operations:
  • Oversee the administration and implementation of pharmacy benefit programs, P&T Committee decisions, and benefit changes.
  • Maintain and update the formulary database, ensuring medication lists are current and reflect the latest clinical guidelines and policy changes.
  • Review and approve testing by PBM and other vendors.
  • Ensure compliance with benefits policy guidelines and formulary requirements.
  • Collaborate with internal teams to resolve claim discrepancies and issues.
  • Support the development and maintenance of policies and procedures (P&Ps) and standard operating procedures (SOPs).
  • Coordinate with external vendors and partners to streamline pharmacy services and resolve operational challenges.
  • Respond to inquiries from Quartz staff, healthcare providers, and members regarding formulary details, medication coverage, and benefit-related questions.
• Pharmacy Specialist, Formulary Support:
  • Draft, format, and maintain prior authorization, step-therapy, and quantity-limit criteria under pharmacist direction.
  • Translate approved policies into system-ready rules and decision trees for prior authorization and claims platforms.
  • Support formulary and medical benefit drug coverage management by preparing formulary change grids, updating drug dictionaries and coverage notes, and tracking non-formulary and exception trends.
  • Perform regulatory plan document reviews as a pharmacy benefit Subject Matter Expert (SME).
  • Aid in change-notification processes and ongoing file maintenance to uphold accuracy and operational efficiency.

Qualifications

• High School Diploma or equivalency.
• 2+ years previous experience in a health care setting, managed care, PBM, or pharmacy setting.
• Knowledge of contracts, applications, products, and regulations (Medicare, ACA, Commercial).
• Knowledge of benefit systems and claims processing systems.
• Strong interest in clinical and operational pharmacy services excellence.
• Familiarity with clinical program components, formulary designs, and prescription drug benefit trends.
• Skills in prioritization, problem-solving, critical thinking, team-building, decision-making, time management, and strategic planning.
• Knowledge of external pharmacy-related quality and performance metrics.
• Excellent organizational and interpersonal skills.
• Obtain Certified Pharmacy Technician (CPHT) certification within 12 months of hire.
• Hold a Pharmacy Technician license in the state of residence.

Benefits

• No weekends – Varying shifts between 7:30am – 5pm, Monday – Friday.
• Starting pay range: $20.72-$25.91/hr., based on skills and experience.
• Robust total rewards package.

Pay and Schedule

• Varying shifts between 7:30am – 5pm, Monday – Friday.
• Starting pay range: $20.72-$25.91/hr., based on skills and experience.

Schedule

• Varying shifts between 7:30am – 5pm, Monday – Friday.

Benefits

• No weekends – Varying shifts between 7:30am – 5pm, Monday – Friday.
• Starting pay range: $20.72-$25.91/hr., based on skills and experience.
• Robust total rewards package.

Qualifications

• High School Diploma or equivalency.
• 2+ years previous experience in a health care setting, managed care, PBM, or pharmacy setting.
• Knowledge of contracts, applications, products, and regulations (Medicare, ACA, Commercial).
• Knowledge of benefit systems and claims processing systems.
• Strong interest in clinical and operational pharmacy services excellence.
• Familiarity with clinical program components, formulary designs, and prescription drug benefit trends.
• Skills in prioritization, problem-solving, critical thinking, team-building, decision-making, time management, and strategic planning.
• Knowledge of external pharmacy-related quality and performance metrics.
• Excellent organizational and interpersonal skills.
• Obtain Certified Pharmacy Technician (CPHT) certification within 12 months of hire.
• Hold a Pharmacy Technician license in the state of residence.

Pay and Schedule

• No weekends – Varying shifts between 7:30am – 5pm, Monday – Friday.
• Starting pay range: $20.72-$25.91/hr., based on skills and experience.

Schedule

• No weekends – Varying shifts between 7:30am – 5pm, Monday – Friday.

Benefits

• No weekends – Varying shifts between 7:30am – 5pm, Monday – Friday.
• Starting pay range: $20.72-$25.91/hr., based on skills and experience.
• Robust total rewards package.

Qualifications

• High School Diploma or equivalency.
• 2+ years previous experience in a health care setting, managed care, PBM, or pharmacy setting.
• Knowledge of contracts, applications, products, and regulations (Medicare, ACA, Commercial).
• Knowledge of benefit systems and claims processing systems.
• Strong interest in clinical and operational pharmacy services excellence.
• Familiarity with clinical program components, formulary designs, and prescription drug benefit trends.
• Skills in prioritization, problem-solving, critical thinking, team-building, decision-making, time management, and strategic planning.
• Knowledge of external pharmacy-related quality and performance metrics.
• Excellent organizational and interpersonal skills.
• Obtain Certified Pharmacy Technician (CPHT) certification within 12 months of hire.
• Hold a Pharmacy Technician license in the state of residence.

Pay and Schedule

• No weekends – Varying shifts between 7:30am – 5pm, Monday – Friday.
• Starting pay range: $20.72-$25.91/hr., based on skills and experience.

Schedule

• No weekends – Varying shifts between 7:30am – 5pm, Monday – Friday.

Benefits

• No weekends – Varying shifts between 7:30am – 5pm, Monday – Friday.
• Starting pay range: $20.72-$25.91/hr., based on skills and experience.
• Robust total rewards package.