Pharmacy Analyst
Posted on :
19-06-2024
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Job Description
Overview:
TekWissen Group is a workforce management provider throughout the USA and many other countries in the world. Our client is a health insurance company. It offers different types of health care coverage plans that include individual and family dental and vision plans for employers etc.
Title: Pharmacy Analyst
Work Location: Lansing MI 48901
Duration: 5 Months
Job Type: Contract
Work Type: Remote
Dept: Medicare Pharmacy Clinic
Engagement Description:
Responsibilities/Tasks
- Assist with all functions related to Pharmacy Benefit Manager (PBM) oversight for Medicare Advantage Part D plans.
- Receive and respond to plan related member and provider inquires.
- Troubleshoot problems inquiries and provide timely response.
- Works with internal and external partners to ensure compliance with CMS regulations.
- Performs routine tracking auditing and reporting of performance in relation to CMS requirements.
- Supports the organization in the event of an internal or external audit
- Coordinate review of Part D member and provider communications.
- Recommends and assists with development of policies and procedures and desk level guides.
- Assists personnel (both internal and external) by answering questions supplying information and maintaining metric and performance dashboards.
- Assist in monitoring reports to track operational effectiveness and vendor service levels.
- Report reconciliation in multiple software environments.
- Proficiency with and responsibly for pulling data reports from readily available databases and reporting tool.
- Maintain drug lists and HCPCs changes or updates.
- Perform other related duties as assigned.
Top 3 Required Skills/Experience The most important musthave skills.
- Retail Pharmacy Healthplan PBM or related experience at least 2 years
- Strong computer skills and use of existing software packages (Excel Power Point Word Outlook etc.)
- Knowledge of claims processing and prescription drug names
Required Skills/Experience
- Detail Oriented
- Organization and time management skills as evidenced by the capacity to prioritize multiple tasks and job duties/responsibilities.
- Capability to work independently and efficiently complete tasks in a fastpaced environment.
- Ability to read and interpret process workflows.
- Strong interpersonal communication skills and experience with interacting across multiple departments.
Preferred Skills/Experience Optional but preferred skills/experience.
- CMS Part D knowledge & CMS regulations
- Knowledge of PBM systems and tools
- Healthplan experience
Education/Certifications Optional but preferred
- CPhT preferred (Certified Pharmacy Tech licensed)
- High school diploma or GED
TekWissen Group is an equal opportunity employer supporting workforce diversity.
Employment Type
Full Time
Key Skills
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