What you’ll do
In a few words…
Contingent upon contract award (First Quarter 2023)
Abarca is igniting a revolution in healthcare. We built our company on the belief that with smarter technology we are redefining pharmacy benefits, but this is just the beginning…
Providing high quality services to client and beneficiaries is at the core of what we do every day! The PBM Operations & Services team is the very heart of Abarca and meets, price eligibility, configurations, and beneficiary services to government services and beyond.
As our systems Pharmacist, you will serve as the lead pharmacist for point of sales (POS) transactions. You will develop operational and clinical policies and procedures, perform claims research and reporting related to edits and denials.
The fundamentals for the job…
- Lead pharmacist for point of sale (POS) transactions.
- Develop operational and clinical policies and procedures.
- Perform claims research and reporting related to edits and denials.
- Utilize PDL cost sheets to document potential system updates to the RTBT Module for identification of drug alternatives to display in EHR systems.
- Collaborate with the PDL Pharmacist to update the PBMS to align with policy recommendations of the PDL Purchasing Pool.
- Cultivates and clearly articulates fact-based insights on customer’s pharmacy program and presents compelling recommendations to help improve program performance and cost savings.
- Ensure CMS’ and URAC Compliance in all clinical processes executed.
What we expect of you:
The bold requirements…
- Doctoral Degree in Pharmacy (required)
- Current/Active Pharmacy License in good standing to practice in Colorado.
- 2+ years of experience as pharmacist.
- 2+ years of professional experience and knowledge of industry standards and best practices regarding large-scale and enterprise-level projects.
- 2+ years of experience in performing similar services on complex systems-based modern technology or operational systems.
- Specific practical experience in their submitted area of expertise.
- Knowledge of and/or experience with PBM clinical operations and Medicare Part.
- Excellent oral and written communication skills.
Physical requirements…
- Must be able to access and navigate each department at the organization’s facilities.
- Sedentary work that primarily involves sitting/standing.
Salary Range
Salary Minimum: $131,700
Salary Maximum: $148,000
This information reflects the anticipated base salary range for this position based on current national data. Minimums and maximums may vary based on location. Actual pay will be adjusted based on an individual’s skills, experience, education, and other job-related factors permitted by law.
Abarca Care Benefits Overview
- Holistic Wellness Program- $300 annual Stipend for each Abarcan to use towards wellness expenses
- Health, Vision and Dental benefits
- Life & Disability Insurance
- Unlimited Personal Time & Vacations
- 3 Wellness Days
- 15 Sick Days
- 401K Matching
- Like Family benefits- Maternity & Paternal leave, Adoption & Summer Childcare Stipend
By applying to this position, you consent and authorize Abarca to share a copy of your resume with the Colorado Department of Health Care Policy & Financing.
The above description is not intended to limit the scope of the job or to exclude other duties not mentioned. It is not a final set of specifications for the position. It’s simply meant to give readers an idea of what the role entails.
Abarca Health LLC is an equal employment opportunity employer and participates in E-Verify. “Applicant must be a United States’ citizen. Abarca Health LLC does not sponsor employment visas at this time”
All qualified applicants will receive consideration for employment and will not be discriminated against on the basis of gender, race/ethnicity, gender identity, sexual orientation, protected veteran status, disability, or other protected group status.
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