Operations Specialist, Experienced

Your Role

The Formulary Management team leads the maintenance of multiple formularies to support competitive health plan products 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 who will lead formulary implementation with the pharmacy claim adjudicator and other vendors to ensure maintenance, validation, and audits are compliant with business needs. This role is responsible for supporting day-to-day operations, maintaining of formulary and drug list databases, maintaining desk-level procedures as well as job aids, and creating reports. The Operations Specialist, Experienced will collaborate cross functionally with the pharmacy claim adjudicator, analytics, benefits and claims, communications, compliance, prior authorization, and customer services departments to communicate formulary and utilization management changes, formulary configuration, and to ensure that formulary decisions are implemented in accordance with health plan client business rules and regulatory requirements.

Our leadership model is about developing great leaders at all levels and creating opportunities for our people to grow – personally, professionally, and financially. We are looking for leaders that are energized by creative and critical thinking, building and sustaining high-performing teams, getting results the right way, and fostering continuous learning.

About Stellarus and the Ascendiun Family of Companies

Stellarus, launched in January 2025, is designed to scale innovative healthcare solutions that support customers in creating a health care experience deserving of their family, friends, and neighbors.


Stellarus is part of a family of organizations that is overseen by a nonprofit corporate entity named Ascendiun. The Ascendiun Family of Companies also includes Blue Shield of California and its subsidiary, Blue Shield of California Promise Health Plan and Altais, a clinical services company.

Stellarus’ vision is to empower its customers to create a healthcare experience that is worthy of their family, friends, and neighbors. Stellarus’ objective is to offer innovative, modern, scalable solutions that challenge the health care status quo. This very closely aligns with Blue Shield of California’s vision by using innovation to improve quality, affordability, and experience for members.

To achieve our mission, we foster an environment where all employees can thrive and contribute fully to address the needs of the various communities we serve. We are committed to creating and maintaining a supportive workplace that upholds our values and advances our goals.

Our Values:

At Stellarus, our core values of agility, trust, drive, courage and service shape our approach to developing innovative product offerings.

Our Workplace Model:

We believe in fostering a workplace environment that balances purposeful in-person collaboration with flexibility - providing clear expectations while respecting the diverse needs of our workforce. Our workplace model is designed around intentional in-person interaction, collaboration, connection, creativity and flexibility:

• For most teams, this means coming into the office two days per week.

• Employees living more than 50 miles from an office location, out of state employees, and employees in certain member-facing roles should work with their manager to determine in-office time based on business need.

• For employees with medical conditions that may impact their ability to work in-office, we are committed to engaging in an interactive process and providing reasonable accommodations to ensure their work environment is conducive to their success and well-being.

The Company reserves the right to require more presence in the office based on business needs, and requirements are subject to change with periodic reviews.

Physical Requirements:

Office Environment - roles involving part to full time schedule in Office Environment. Based in our physical offices and work from home office/deskwork - Activity level: Sedentary, frequency most of work day.

Please click here for further physical requirement detail.

Equal Employment Opportunity:

External hires must pass a background check/drug screen. Qualified applicants with arrest records and/or conviction records will be considered for employment in a manner consistent with Federal, State and local laws, including but not limited to the San Francisco Fair Chance Ordinance. All qualified applicants will receive consideration for employment without regards to race, color, religion, sex, national origin, sexual orientation, gender identity, protected veteran status or disability status and any other classification protected by Federal, State and local laws.