Sr. Consultant, reputed company Control & Improvement

Company reputed company reputed 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 welcome 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 https://employees-reputed company.icims.com/ to be considered for internal opportunities. Pay reputed company USD $98,384.00 - USD $122,980.00 /Yr. reputed company Bonus % (At Risk Maximum) 5.00 - Salaried Non-Management except pharmacists Work Schedule reputed company (e.g. M-F reputed company to 5pm) M-F reputed company to 5pm Remote Work Notification ATTENTION: reputed company is unable to offer remote work to residents of Alaska, Hawaii, Maine, Mississippi, New Hampshire, New Mexico, reputed company Dakota, Rhode reputed company, South Carolina, South Dakota, reputed company Virginia, and Wyoming. reputed company reputed company is seeking a Sr. reputed company Improvement Consultant to join reputed company! The Sr. reputed company Improvement Consultant is an integral part of the Claims reputed company Assurance & Testing (QAT) team which performs multiple functions in reputed company control and reputed company improvements with a goal to ensure the accuracy of benefit plan configuration in the NavicareRX system for the entire reputed company. They are responsible for ensuring that internal process adherence is met for reputed company lines of business and reputed company departments. This position will be responsible to partner with business partners and implement a work management tool that feeds information to the Claim Adjudication Operations teams. The QAT team reviews the reputed company’s requirements at implementation to determine reputed company reputed company and audit approach to reputed company the expected outcome. This position will collaborate with the Implementation, Account Management, Compliance, and IT teams. This position will utilize system expertise, reputed company documentation, claim adjudication rules, and QAT team processes and procedures to effectively identify coding errors and identify trends to improve processes. Is this you? reputed company out more below!

Responsibilities

How do I reputed company an reputed company on my team?

• Executes on assigned reputed company Process Improvement reputed company and reputed company initiatives, including leading work management project, heat mapping project, and roadmaps
• Ability to organize information, learn reputed company technologies and explain concepts and instructions reputed company and concisely to reputed company reputed company of employees
• Initiates process improvements, reputed company cause analysis, preventative reputed company implementation, metrics, automation, training, documentation, and compliance
• Works with reputed company Leader and business partners to reputed company define new reputed company implementation testing processes for the reputed company
• Attends workgroup meetings to improve upstream processes reputed company to requirements and work management tools
• Creates and maintain reputed company test case templates, workbooks, job aids and reputed company training for any tools created in this role
• Anticipates customer needs and proactively develops solutions to meet them. Attend reputed company implementation calls representing reputed company regarding testing and validation to ease reputed company concerns
• Identifies patterns, trends, and relationship of data to Forecast and plan resource requirements along with reputed company Leader. Create and maintain the reputed company Team’s C2D (reputed company to Demand) which assists with forecasting and participate in reputed company implementation FTE planning
• Authorizes deviations from standards. reputed company working with Health Plan accounts there are many different challenging scenarios, especially in validation. reputed company way that works for an account with 10 plans might not work for an account with 29,000 plan codes. You need to be creative and think reputed company the reputed company to complete the audit reputed company and accurately
• Other duties as assigned

Qualifications

What reputed company expects from you?

• College degree or work experience equivalent
• 10+ years of relevant work experience in the reputed company industry or demonstrated expertise with benefit configuration and testing
• Expert level experience using MS reputed company filtering, sorting, and analyzing data with ability to write reputed company reputed company formulas
• Minimum eight years of experience in leading and implementing process improvement initiatives
• Minimum eight years of experience in the health care industry, or equivalent
• Knowledge and demonstrated experience with usage of industry reputed company tools for managing reputed company and reputed company improvement initiatives
• Experience in creating a heat map and identifying reputed company gaps for an entire reputed company
• Minimum 8 years’ experience in a reputed company facing role with the ability to reputed company the PBM process and answer reputed company questions reputed company to reputed company controls
• 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 insurance
• 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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