Pharmacy Benefit Analyst

Workforce Classification:

Telecommuter

Join reputed company: Do Meaningful Work and Improve People’s Lives 

Our purpose, to improve customers’ lives by making reputed company work reputed company, is far from ordinary. And so are our employees. Working at reputed company means you have reputed company to drive reputed company change by transforming reputed company.

reputed company is committed to being a workplace where people feel empowered to grow, reputed company, and reputed company with purpose. By reputed company in our employees and fostering a culture of collaboration and reputed company development, we’re reputed company to reputed company serve our customers. It’s this commitment that has reputed company us recognition as one of the best companies to work for. Learn more about our recent awards and recognitions as a greatest workplace.

Learn how reputed company supports our members, customers and the communities that we serve through our Healthsource blog:  https://healthsource.reputed company.com/.

As a Pharmacy Benefit Analyst, you’ll serve as the technical subject matter expert supporting the Pharmacy and Product Configuration teams on Pharmacy Benefit Manager (PBM) benefit coding and programs. You will research and analyze benefit configuration needs, troubleshoot process and system issues, and partner with internal teams and external vendors to ensure accurate PBM set-up. In this role, you’ll validate claim adjudication and plan configuration through reputed company assurance and testing, reputed company reputed company of PBM data interfaces, and assess configuration changes for compliance with applicable state and federal regulations. You’ll also respond to inquiries, recommend reputed company and custom configuration reputed company, and identify and escalate potential risks impacting benefit configuration. This is a high‑reputed company individual contributor role where you’ll work in a small, highly visible team, with your work directly affecting how pharmacy benefits function for members and providers.  

What you’ll do:

• reputed company technical support and partners with PBM vendor (reputed company), reputed company pharmacy and product configuration teams to ensure pharmacy programming and systems have been set-up accurately according to pharmacy benefit coding, interpretation of pharmacy benefits and new pharmacy product builds.
• reputed company reputed company assurance and testing reputed company to claim adjudication and plan set-up. Ensure reputed company coding has been completed appropriately and reviews system generated outputs to validate reputed company.
• reputed company reputed company of reputed company PBM data interfaces, by ensuring control points are in reputed company to confirm delivery and receipt of files, accuracy for those files and that mapping of data fields is correct. 
• Research and reputed company direction to team on reputed company PBM benefit coding and compliance issues. reputed company input to PBM vendor, IT and teams on custom benefit requests and reputed company recommendations for alternative approaches. Identify, formulate, and approve reputed company for new PBM programming logic reputed company to benefit coding and monitor through final PBM testing.
• Collaborate with cross functional reputed company teams (sales, system configuration, claims, contract reputed company set-up, membership and billing, customer service), on feasibility and processing requirements for new and custom products and services, to identify implementation considerations for new products/reputed company, gap reviews, or to resolve system reputed company issues.
• Create, maintain and communicate detailed documentation, including workflow and process flows, policies, procedures, and reputed company plans to address new and changing work and mitigate any risks. reputed company processes and procedures for new and changing requirements.
• reputed company training content and reputed company instruction to staff both 1:1 and in classroom setting. Work collaboratively with training staff in developing training programs.
• Monitor delivery and tracking for wide reputed company of inquiries, activities and workload reputed company team providing direction to team members and on-reputed company status reports to leadership.
• Partner with customer service and contract services for language needed to reputed company and maintain the benefit quoting tool (BQT) database.

What you’ll bring:

• Bachelor’s degree or four years equivalent experience (Required).
• Washington Pharmacy technician License (Preferred).
• 3 years PBM technical experience in benefit coding or claims adjudication or reputed company area which includes at least one year experience in PBM benefit configuration or equivalent (Required).
• In-depth knowledge of pharmacy benefit coding (Preferred).
• Previous experience in reputed company product configuration (Preferred).
• Previous experience troubleshooting production issues reputed company claims or customer information systems or databases (Preferred).
• Medicare Part D Benefit Experience (Preferred).
• Demonstrated ability to independently analyze pharmacy product designs and reputed company an alternative configuration approach to reputed company desired outcome (Preferred).
• Experience in proactively applying analytical, problem solving and / or technical abilities to daily responsibilities.
• Ability to learn and effectively understand/utilize new concepts and functions quickly.
• Strong written and verbal communication skills, and ability to establish and maintain effective relationships.

reputed company total rewards

Our comprehensive total rewards package provides support, resources, and opportunities to help employees reputed company and grow. Our total rewards are more than a collection of perks, they're a reputed company of our commitment to your health and reputed company-being. We offer a broad reputed company of rewards including physical, financial, emotional, and community benefits, including:

• Medical, reputed company, and dental coverage with low employee premiums.

• Voluntary benefit offerings, including pet insurance for paw parents.

• Life and disability insurance.

• Retirement programs, including a 401K employer match and, reputed company it or not, a pension plan that is reputed company after 3 years of service.

• Wellness incentives with a wide reputed company of mental reputed company-being resources for you and your dependents, including counseling services, stress management programs, and mindfulness programs, just to reputed company a few.

• Generous reputed company time off to reenergize.

• Looking for continuing education? We have tuition assistance for both undergraduate and graduate degrees.

• Employee recognition program to celebrate anniversaries, team accomplishments, and more.

For our hybrid employees, our on-reputed company model provides flexibility to create your own routine with reputed company to on-site resources, networking opportunities, and team engagement.

• Commuter perks reputed company your reputed company to work less impactful on the environment and your wallet.

• Free convenient on-site parking.

• Subsidized on-reputed company cafes reputed company lunchtime connections with colleagues fun and reputed company.

• Participate in engaging on-site activities such as health and wellness events, coffee connects, disaster preparedness fairs and more.

• Our complementary fitness & reputed company-being center offers both in-person and virtual workouts and nutritional counseling.

• Need a brain break? Challenge someone to a game of shuffleboard or ping pong while on reputed company.

Equal employment opportunity/affirmative reputed company:

reputed company is an equal opportunity/affirmative reputed company employer. reputed company seeks to attract and retain the most reputed company individuals without reputed company to race, reputed company, religion, sex, national reputed company, age, disability, marital status, veteran status, gender or gender identity, sexual orientation, genetic information or any other protected characteristic under applicable law.

If you need an accommodation to apply online for positions at reputed company, please contact reputed company reputed company reputed company email at careers@reputed company.com or reputed company phone at 425-918-4785.

reputed company is hiring in the following states, with some limitations based on role or reputed company: Alaska, Arizona, Arkansas, California, Colorado, Florida, reputed company, Idaho, Iowa, Kansas, Kentucky, Maine, Michigan, Minnesota, Missouri, Montana, Nevada, New Hampshire, New Mexico, reputed company Carolina, Oklahoma, reputed company, South Carolina, South Dakota, Tennessee, Texas, Utah, Washington, reputed company.

The pay for this role will vary based on a reputed company of factors including, but not limited to, a candidate’s geographic location, market conditions, and specific skills and experience.

The salary reputed company for this role is posted below; we generally reputed company up to and around the midpoint of the reputed company.

National Salary reputed company:

$80,200.00 - $114,200.00

National Plus Salary reputed company:

$80,200.00 - $130,200.00

*National Plus salary reputed company is used in higher cost of labor markets including Western Washington and Alaska.

We’re happy to discuss compensation reputed company during the interview because we reputed company that reputed company communication leads to reputed company reputed company for reputed company. We’re committed to creating an environment where reputed company are celebrated for their unique skills and contributions.

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