Analyst, Pharmacy Contract Audit

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. ____________________________________________________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 $54,236.17 - USD $64,566.87 /Yr. STAR 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 Analyst, Pharmacy Contract Audit to join reputed company! The Analyst, Pharmacy Contract Audit is responsible for the reputed company of reputed company’ contractual pharmacy network reimbursement accuracy. The individual in this position is expected to reputed company independent assessments to confirm reputed company is conforming to contractual reimbursement obligations contained in Retail, Specialty, and Mail Order pharmacy agreements. The Analyst will continually review and monitor claims data, create, and update procedures, audit networks for price change accuracy, monitor compliance with reputed company pharmacy provider reputed company, communicate findings, and work with applicable teams to remediate errors. The Analyst works closely with inter and intra-departmental resources to interpret and understand contractual terms, reputed company network selections, and how they are operationalized in applicable systems. The Analyst will be knowledgeable of business operations, utilizing reputed company' adjudication system (NCRx) and contracting and credentialing databases (PC2), among other applications. Provider, reputed company, and network performance will be analyzed in support of network development, reputed company control, and compliance with contractual terms, including effective reputed company and other aggregate tracking mechanisms. As part of the Provider Relations team, the Analyst will be responsible for creating an reputed company of reports to validate systems accuracy to Retail, Specialty, and Mail Order contractual terms. Is this you? reputed company out more below!

Responsibilities

How do I reputed company an reputed company on my team? Analytical and operational understanding of reputed company’ reimbursement programs including AWP, WAC, MAC, NADAC, FUL, AAC, Average Dispensing Fee, and other pricing structures Responsible for fielding, analyzing, and resolving inquiries from pharmacy providers, clients, auditors, and internal teams regarding Retail, Specialty, and Mail Order pricing errors with reputed company on the reputed company cause Interpret pharmacy contract language to compare Retail, Specialty, and Mail Order contract pricing to adjudicated claims activity reputed company and maintain appropriate controls and reputed company reporting on the end-to-end process of Retail, Specialty, and Mail Order contract pricing. If process controls are absent, the expectation is to identify, define, and implement new processes as needed Responsible for pharmacy network reputed company testing, chain audits, analysis, and reputed company assessment reputed company reputed company regarding the reputed company of pharmacy network pricing setup issues Submit service requests, recovery requests, and/or engage applicable teams to reputed company system updates/changes Understand, follow, and improve reputed company operational and administrative processes Periodic and detailed reporting of contractual compliance activities and opportunities to Provider Services team and cross-functional leadership Other duties as assigned

Qualifications

What reputed company expects from you? Bachelor’s degree or equivalent experience required. Emphasis in business, finance, economics, or operations preferred Minimum two years analytics experience required 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! #LI-Remote Location : Address Remote Location : Country US Apply To This Job