Exemption Status:
United States of America (Exempt)
$60,987 - $80,808 - $100,628
“Pay scale information is not necessarily reflective of actual compensation that may be earned, nor a promise of any specific pay for any selected candidate or employee, which is always dependent on actual experience, education, qualifications, and other factors. A full review of our comprehensive pay and benefits will be discussed at the offer stage with the selected candidate.”
This position is not eligible for Sponsorship.
MedImpact Healthcare Systems, Inc. is looking for extraordinary people to join our team!
Why join MedImpact? Because our success is dependent on you; innovative professionals with top notch skills who thrive on opportunity, high performance, and teamwork. We look for individuals who want to work on a team that cares about making a difference in the value of healthcare.
At MedImpact, we deliver leading edge pharmaceutical and technology related solutions that dramatically improve the value of health care. We provide superior outcomes to those we serve through innovative products, systems, and services that provide transparency and promote choice in decision making. Our vision is to set the standard in providing solutions that optimize satisfaction, service, cost, and quality in the healthcare industry. We are the premier Pharmacy Benefits Management solution!
Job Description
Summary
The Formulary Administration Specialist I participates in the design and validation of pharmacy benefit management plans. This position ensures accurate coding of plan specific information into formulary systems and provides comprehensive support to external clients related to formulary change requests. Ensures appropriate service levels are maintained to meet corporate standards for performance and quality.
Essential Duties and Responsibilities include the following.
Drug Updates for Commercial Clients:
o Review weekly/monthly/quarterly drug update projects.
o Prepare weekly/monthly/quarterly formulary files for pharmacist review.
o Monitors/updates Drug Rules and Auto-Coding rules.
o Research and respond to client inquiries; escalates to managers/pharmacists for complex issues.
Formulary Mailbox and Client Management Platform:
o Triages inquiries; serves as a resource for troubleshooting basic issues; escalates to managers/pharmacists for complex issues.
o Drafts client communication to be reviewed by management; customizes templates with client instructions including clarification of roles/responsibilities between MedImpact and the client; prepares routine client responses to email and case queries.
Negative Formulary Changes Process:
o Compile member disruption reports for pharmacist review.
o Review member letters before letters are distributed.
Formulary Process
o Build formulary shells with pharmacists.
Provide claims analysis support.
Works to gain a solid understanding of Formulary and PBM operations through on-the-job training, in- house educational opportunities and related external seminars or coursework.
Other duties as assigned.
Supervisory Responsibilities
No supervisory responsibilities
Client Responsibilities
This is an internal and external client facing position that requires excellent customer service skills and interpersonal communication skills (listening/verbal/written). One must be able to; manage difficult or emotional client situations; Respond promptly to client needs; Solicit client feedback to improve service; Respond to requests for service and assistance from clients; Meet commitments to clients.
Qualifications
To perform this job successfully, an individual must be able to perform each essential duty satisfactorily. The requirements listed below are representative of the knowledge, skill, and/or ability required. Reasonable accommodation may be made to enable individuals with disabilities to perform the essential functions.
Education and/or Experience
Associate’s degree and 2+ years’…