Formulary Administration Specialist
MedImpact
Formulary Administration Specialist
MedImpact
Independent PBM reducing prescription costs
“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!
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’ experience or equivalent combination of education and experience.
Computer Skills
To perform this job successfully, an individual should have a good working knowledge of Microsoft Office Suite (Word/Excel/Outlook) and good familiarity working with databases.
Certificates, Licenses, Registrations
Current Pharmacy Technician License and/or CPhT certification without restriction.
Other Skills and Abilities
Reasoning Ability
Mathematical Skills
Language Skills
Competencies To perform the job successfully, an individual should demonstrate the following competencies:
Composure
Decision Quality
Organizational Agility
Problem Solving
Customer Focus
Drive for Results
Peer Relations
Time Management
Dealing with Ambiguity
Learning on the Fly
Political Savvy
Physical Demands
The physical demands described here are representative of those that must be met by an employee to successfully perform the essential functions of this job. Reasonable accommodation may be made to enable individuals with disabilities to perform the essential functions.
While performing the duties of this job, the employee is regularly required to sit and talk or hear. The employee is regularly required to stand; walk; use hands to finger, handle, or feel and reach with hands and arms. The employee must occasionally lift and/or move up to 25 pounds. Ability to maintain clear near visual acuity at approximately 20 inches or less (i.e., “close vision”) to accurately read fine print, view computer screens, and handle small objects. Requires adequate color vision and depth perception to support safety and precision in detail-oriented tasks.
Work Environment
The work environment characteristics described here are representative of those an employee encounters while performing the essential functions of this job. Reasonable accommodation may be made to enable individuals with disabilities to perform the essential functions.
This position may regularly be exposed to or encounter moving mechanical parts, high, precarious places, fumes, or airborne particles, toxic or caustic chemicals, outdoor weather conditions, risk of electrical shock or vibration. The noise level in the work environment is usually moderate (examples: business office with computers and printers, light traffic).
Work Location
This position works on-site at the San Diego Headquarters or other company location (or from a remote location with management approval based on business requirements). Must provide adequate support to internal clients; be available for regular interactions and coordination of work with other employees, colleagues, clients, or vendors; as well as be available to facilitate effective decisions through collaboration with stakeholders.
Working Hours
This is an exempt level position requiring the incumbent to work the hours required to fully accomplish job responsibilities and meet deadlines for work deliverables. The individual must have the flexibility to work beyond traditional hours and be able to work nights, weekends or on holidays as required. Work hours may be changed from time to time to meet the needs of the business. Typical core business hours are Monday through Friday from 8:00am to 5:00pm.
Travel
This position requires domestic travel of up to 5% of the time.
Medical / Dental / Vision / Wellness Programs
Paid Time Off / Company Paid Holidays
Incentive Compensation
401K with Company match
Life and Disability Insurance
Tuition Reimbursement
Employee Referral Bonus
To explore all that MedImpact has to offer, and the greatness you can bring to our teams, please submit your resume to www.medimpact.com/careers
MedImpact, is a privately-held pharmacy benefit manager (PBM) headquartered in San Diego, California. Our solutions and services positively influence healthcare outcomes and expenditures, improving the position of our clients in the market. MedImpact offers high-value solutions to payers, providers and consumers of healthcare in the U.S. and foreign markets.
To perform this job successfully, the successful candidate must be able to perform each essential duty satisfactorily. The requirements listed are representative of the knowledge, skill, and/or ability required.
Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.
The above statements are intended to describe the general nature and level of work being performed by people assigned to this classification. They are not intended to be construed as an exhaustive list of all responsibilities, duties, and skills required of personnel so classified.
MedImpact is an independent pharmacy benefit manager serving health plans, self-funded employers, and government entities. It designs and administers prescription drug benefits, including formulary management, benefit design, utilization management, claims processing, clinical programs, and specialty drug management to cut costs and improve health outcomes. It differentiates itself as independent (not owned by a payer or drugstore) with transparent and flexible pricing across a broad client base and end-to-end benefit management. Its goal is to lower prescription drug costs for clients while improving member health through data-driven, transparent, and comprehensive programs.
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