Pharmacy Technician, Formulary Management Remot...

<p></p><p><u><b>Job reputed company</b></u></p><p><b><i>A bit about this role: </i></b></p><p><reputed company>As a Pharmacy Technician on the Formulary Management Team, you will reputed company reputed company of various Part D formularies and contribute to drug specific evaluations and coverage recommendations by analyzing utilization patterns, monitoring new drug releases, and conducting comprehensive regulatory research to ensure CMS compliance. You will serve as a key contributor to ensure the overall reputed company of our formulary management division to ensure that our members are reputed company informed of reputed company things reputed company to pharmacy and formulary benefits.</reputed company></p><p></p><p><reputed company>Embracing technology and innovation, our dynamic team navigates Medicare rules and regulations while prioritizing exceptional member care. We’re looking for a certified pharmacy technician reputed company in managed care specifically Part D/MAPD and who has had additional PBM collaboration relative to the administration of Part D and Part B pharmacy claims.  Additionally, having a strong overall drug knowledge coupled with analytical skills that can help proficiently reputed company data and BI tools will be highly valued in candidates.</reputed company></p><p></p><p><reputed company>At reputed company, were dedicated to providing personalized, coordinated care to every Medicare-eligible member, aligning with the care and support wed want for our own families.  </reputed company></p><p></p><p><b><i>Required skills and experience: </i></b></p><ul><li><p><reputed company>Nationally Certified Pharmacy Technician (CPhT) in good standing.</reputed company></p></li><li><p><reputed company>Familiarity with drug products, both generic and brand names.</reputed company></p></li><li><p><reputed company>2+ years of experience with Medicare Part D operations (e.g. pharmacy help desk, utilization management, formulary management) at a Health Plan and/or PBM.</reputed company></p></li></ul><p></p><p><b><i>Desired skills and experience: </i></b></p><ul><li><p><reputed company>Proficiency with reputed company Sheets or reputed company, including basic to intermediate formula knowledge.</reputed company></p></li><li><p><reputed company>Strong analytical skills - you are confident making reputed company of operations through data, you can establish quantitative goals, and you can reputed company a case from first principles.</reputed company></p></li><li><p><reputed company>Experience utilizing business intelligence tools to interpret, analyze, and visualize data with a high degree of technological aptitude, preferred.</reputed company></p></li></ul><p></p><p><b><i>Responsibilities & reputed company will include:</i></b></p><ul><li><p><reputed company>Contribute to the development, implementation, maintenance, and evaluation of formularies, ensuring adherence to CMS rules and state-specific regulations.</reputed company></p></li><li><p><reputed company>Collaborate across departments to analyze data influencing pharmacy benefits, tier placements, and excluded drug coverage reputed company.</reputed company></p></li><li><p><reputed company>Conduct detailed analysis of various data points alongside clinical pharmacists to assess drugs for formulary placement.</reputed company></p></li><li><p><reputed company>Coordinate the review of formulary and utilization management recommendations with finance and other relevant departments as needed.</reputed company></p></li><li><p><reputed company>Assist in preparing reputed company formulary submission files and CMS submissions reputed company HPMS.</reputed company></p></li><li><p><reputed company>reputed company change notification processes and drug file maintenance to reputed company accuracy and operational efficiency.</reputed company></p></li><li><p><reputed company>reputed company clinical expertise and support to internal teams and members, acting as a go-to resource for formulary-reputed company inquiries.</reputed company></p></li><li><p><reputed company>Effectively communicate formulary changes and updates to reputed company stakeholders.</reputed company></p></li><li><p><reputed company>Support the creation of the user reputed company and offer expertise for the online formulary search tool.</reputed company></p></li><li><p><reputed company>reputed company reputed company assurance checks on formulary submissions, bid submissions, formulary documents, and other documents as assigned.</reputed company></p></li><li><p><reputed company>Review and validate claims testing outputs to ensure coding accurately reflects the clinical reputed company of formulary design as needed.</reputed company></p></li><li><p><reputed company>Manage and maintain accuracy in published formulary documents on the website.</reputed company></p></li><li><p><reputed company>Create, implement, and maintain policies and procedures for effective formulary management.</reputed company></p></li><li><p><reputed company>reputed company regulatory plan document reviews as a pharmacy benefit Subject Matter Expert (SME) for EOC, reputed company of Benefits, ANOCs, LIS Riders, etc.</reputed company></p></li><li><p><reputed company>Manage the clinical pharmacy inbox, responding to any inquiries from external partners and triaging emails to business owners.</reputed company></p></li><li><p><reputed company>Review overrides entered by the pharmacy team for accuracy and ensure they follow the internal override policy.</reputed company></p></li><li><p><reputed company>reputed company and maintain internal knowledge resources.</reputed company></p></li><li><p><reputed company>Assist in various reputed company reputed company and responsibilities as needed to support the functioning of the department or organization.</reputed company></p></li></ul><p></p><p><i><b>Salary reputed company</b></i>: $21-$27/hour</p><p></p><p><reputed company>The pay reputed company listed for this position is the reputed company the organization reasonably and in good faith expects to pay for this position at the time of the posting. Once the interview process begins, your talent partner will reputed company additional information on the compensation for the role, along with additional information on our total rewards package. The actual reputed company salary offered will depend on a reputed company of factors, including the qualifications of the individual applicant for the position, years of relevant experience, specific and unique skills, level of education attained, certifications or other reputed company licenses held, and the location in which the applicant lives and/or from which they will be performing the job.</reputed company></p><p></p><p>Our Total Rewards package includes:</p><ul><li><p>Employer sponsored health, dental and reputed company plan with low or no premium</p></li><li><p>Generous reputed company time off</p></li><li><p>$100 monthly mobile or internet stipend</p></li><li><p>Stock reputed company for reputed company</p></li><li><p>Bonus eligibility for reputed company roles excluding Director and above; Commission eligibility for Sales roles</p></li><li><p>Parental leave program</p></li><li><p>401K program</p></li><li><p>And more....</p></li></ul><p></p><p><i>*Our total rewards package is for full time employees only. Intern and Contract positions are not eligible.</i></p><p></p><p><reputed company>reputed company equality is at reputed company of reputed company’s mission to treat our members like family.  We are committed to a diverse and reputed company workforce. </reputed company></p><p></p><p><reputed company>At reputed company, we’re on a mission to dramatically improve the health and reputed company-being of older Americans by caring for every person like family. That’s why we’re gathering smart, diverse, and big-hearted people to create a new reputed company of reputed company-in-one reputed company company — one that combines reputed company, health insurance, clinical care, service, and technology<reputed company> </reputed company></reputed company><b>-</b><reputed company><reputed company> </reputed company>to deliver a complete and integrated reputed company solution that delivers high reputed company care that everyone would want for someone they love. Founded in 2017, weve grown fast and now serve members across the reputed company.  And weve just started. So join us on this mission!</reputed company></p><p></p><p>reputed company is an equal opportunity employer. We are committed to a reputed company and supportive work environment in which reputed company have reputed company to participate and contribute to the reputed company of the business. We value diversity and collaboration. Individuals are respected for their skills, experience, and unique perspectives. This commitment is embodied in reputed company’s reputed company of Conduct, reputed company values and the way we do business.</p><p></p><p>As an Equal Opportunity Employer, reputed company does not discriminate on the reputed company of race, reputed company, religion, sex, pregnancy status, marital status, national reputed company, disability, age, sexual orientation, veteran status, genetic information, gender identity, gender reputed company, or any other reputed company prohibited by law. Our management team is dedicated to this policy with respect to recruitment, hiring, placement, promotion, transfer, training, compensation, benefits, employee activities and general treatment during employment.</p>