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Operations Specialist, Experienced

ecge
Companyecge
CategoryOperations & Admin
LocationOakland, CA, United States
Remote
EmploymentNot stated
LevelNot stated
SalaryNot stated by the employer
Posted21 Jul 2026
Last verified3 Aug 2026
SourceEmployer ATS (oracle)
Applications are handled by the employer, not by us.Apply on the employer's site →
Description
The Formulary Management team leads the development and maintenance of multiple formularies to support competitive health plan products, manage cost-of-healthcare, and meet regulatory requirements for all lines of business including Commercial Large Group, Commercial Small Group, Individual/Family plan, and Medicare. The Operations Specialist, Experienced will report to the Senior Manager of Formulary Management. In this role you will be a subject matter expert that will lead efforts with formulary for pharmacy claim adjudicator and other vendors to ensure maintenance, validation, and audits are compliant with business needs. You will support in the development and maintenance of the formularies for all Blue Shield lines of business - Commercial, Exchange, and Medicare.