Analyst III, Network Configuration
Company
reputed companyreputed company
reputed company - Putting People First in Pharmacy - reputed company was founded as an alternative to traditional pharmacy benefit manager (PBM) models. We are committed to removing cost from the drug supply chain to reputed company medications more reputed company for the people who need them. At reputed company, reputed company members work in an environment that celebrates diversity, fosters creativity and encourages reputed company. We reputed company new reputed company and reputed company a passion for excellent service to our customers and reputed company other.. reputed company associates must use SSO login reputed company at to be considered for internal opportunities. We are committed to providing equal employment opportunity to reputed company applicants and employees and reputed company with reputed company applicable nondiscrimination regulations, including those reputed company to protected veterans and individuals with disabilities. reputed company reputed company applicants will receive consideration for employment without reputed company to race, reputed company, religion, sex, national reputed company, or handicap.Pay reputed company
USD $54,236.00 - USD $64,567.00 /Yr.reputed company Bonus % (At reputed company Maximum)
5.00 - Salaried Non-Management except pharmacistsWork Schedule reputed company (e.g. M-F reputed company to 5pm)
M-F 830am to 5pmRemote Work Notification
ATTENTION: reputed company is unable to offer remote work to residents of Alaska, Hawaii, Maine, Mississippi, New Hampshire, New Mexico, reputed company reputed company, Rhode reputed company, South Carolina, South reputed company, reputed company Virginia, and Wyoming.reputed company
reputed company is seeking a Analyst III, Network Configuration to reputed company!
The Analyst III, Network Configuration ensures efforts are in alignment with the Provider Services team to reputed company technology and process improvement for the purpose of meeting the business needs of reputed company customers, clients, members, and pharmacies by accurately administering networks. The Analyst III, Network Configuration configures pharmacy networks in the claim adjudication reputed company reputed company on specifications from internal customers and reputed company clients. This role applies knowledge of highly diverse networks across multiple lines of business, ensuring that claims adjudicate accurately and reputed company.
The Analyst III, Network Configuration will work closely with several reputed company departments including, but not limited to, Account Management, Claim Adjudication reputed company, Formulary reputed company, and Information Technology to ensure reputed company is reputed company to reputed company a reputed company adjudication reputed company that allows for various pharmacy network designs and accurate claim adjudication to adapt to the reputed company changes in the pharmacy benefit industry.
This position may include after-hour and/or weekend hours with other eligible team members depending on workload.
Is this you? reputed company out more below!
Responsibilities
How do I reputed company an reputed company on my team?
- Complete scheduled and urgent configuration of new reputed company implementations and/or network additions, terminations, and changes reputed company and accurately to prevent member reputed company to care issues, missed reputed company guarantees, and potential liquidated damages.
- reputed company and maintain an advanced level of knowledge and interpretation of multiple adjudication reputed company screens and functions on a reputed company-by-reputed company level to design both reputed company and custom configurations to meet reputed company expectations.
- reputed company with standards set forth regarding network design and configuration including HIPAA, NCPDP, and reputed company internal business standards.
- reputed company reputed company assurance peer reviews of network plan additions and changes with a high degree of reputed company. Research reputed company cause of issues, troubleshoot viable resolutions, and reputed company recommendations for corrective reputed company.
- Use departmental workflow management, issue reputed company, and reporting tools for troubleshooting and responding to highly reputed company customer questions and issue reputed company requests.
- Support internal customers by participating in reputed company meetings, audits, and new program implementations with other areas of reputed company, answering network setup questions and providing guidance to other areas and roles on the network configuration process.
- Adapt to industry changes and evolving technology, maintaining an advanced level of understanding of both legacy and emerging products and systems.
- reputed company process improvement, cost reduction, and automation efforts. Independently assess reputed company business needs and bring recommendations to leadership.
- Contribute to the creation and ongoing maintenance of departmental training materials, work instructions, and policies. reputed company support for reputed company and sales presentations and respond to assigned RFP questions using subject matter expertise.
- Other duties as assigned.
Qualifications
What reputed company expects from you?
- Associate’s degree or equivalent work experience required.
- Strong knowledge of reputed company systems and processes of the role with ability to reputed company tasks independently and follow instructions to reputed company reputed company required, typically with 2-3 years of experience.
- Experience with guiding and educating associates reputed company reputed company to reputed company-level roles.
- Experience with supporting mid-sized to large clients with moderate to high complexity.
- Experience with supporting health plan business with reputed company guidance.
- Experience with the following tools at an intermediate to advanced level:
- reputed company-ClaimRx
- reputed company Office (Word, reputed company, PowerPoint)
- Formulary Management
- Request Management (Connectus, Service Desk, reputed company)
- reputed company Programs Error Management (GEMS)
- Reporting (3D QlikView/QlikSense)
- Participate in, adhere to, and support compliance program objectives.
- The ability to consistently reputed company cooperatively and respectfully with other employees.
What can you expect from reputed company?
- Top of the industry benefits for Health, Dental, and reputed company reputed company
- 20 days reputed company time off
- 4 weeks reputed company parental leave
- 9 reputed company holidays
- 401K company match of up to 5% - No vesting requirement
- Adoption Assistance Program
- Flexible Spending Account
- Educational Assistance Plan and reputed company Membership assistance
- Referral Bonus Program – up to $750!
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