Exemption Status:
United States of America (Non-Exempt)
Exemption Status:
$34,265 - $43,264 - $52,262
“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.”
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!
Job Description
Position Summary:
Working as the liaison between the member, healthcare providers, and prescription drug assistance programs, the Specialty Drug Program Administrator helps to connect members to prescription drug assistance programs that will facilitate members to receive medications at no charge or at a discounted price. The Specialty Drug Program Administrator will work directly with members and physicians to ensure all required paperwork for a MAP/PAP application is completed and submitted to the manufacturer. Once a coverage determination has been made by the manufacturer, the Specialty Drug Program Administrator will work directly with the PBM and dispensing pharmacy to ensure the claim approves appropriately and the member receives their medication.
Essential Functions and Responsibilities include the following. Other duties may be assigned.
- Perform patient & physician outreach; educating patient on potential Alternate Funding programs as they relate to their specific benefit.
- Provide all necessary paperwork and documentation to the patient and physician and follow-up on appropriate manufacturer program to determine patient eligibility.
- Enter benefit overrides as applicable to ensure pharmacy receives a paid claim once funding has been secured.
- Provide all necessary billing information to the dispensing pharmacy once funding has been approved.
- Ensure patients are aware of documentation requirements for the program to ensure application for refills or new application process can proceed.
- Thoroughly document patient contacts, patient information, and other related agency activities in the case file.
- Performs other duties as assigned by Principal Enterprise Drug Product Solutions.
Supervisory Responsibilities
This job has 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). Client and/or member issues will require claims lookup and evaluation. One must be able to; Respond promptly to client needs; Solicit client feedback to improve service; Respond to requests for service and assistance from clients; Meet commitments to clients; Manage difficult or emotional client situations and respond to RFP inquires related to the specified products, applications and solutions assigned.
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 accommodations may be made to enable individuals with disabilities to perform the essential functions.
Education and/or Experience
High School diploma and three (3) to five (5) years of related experience; or equivalent experience in a Pharmacy Benefit Management (PBM), Pharmacy, Specialty Pharmacy or healthcare environment required. Three (3) to five (5) years’ experience as a Patient Advocate or related experience as applicable to the role.
Computer Skills
Strong proficiency with MS Office / Word, PowerPoint, Excel, Project, Visio, and Outlook to create complex documents, manage schedules, and analyze data. Strong proficiency with MedImpact and/or MedImpact Direct systems including MedAccess, MedOptimize, and Salesforce. Skills that are desirable, but not required include SQL query development, Golden32 or other equivalent database browsing software, and Excel macro programming.
Other Skills and Abilities
Ability to effectively recognize complex problems and apply analytic and critical thinking skills to innovate solutions. Ability to perform root cause analysis of member and/or client issues. Ability to exercise sound judgment and decision-making. Ability to collaborate on cross-functional projects and liaise with stakeholders on both the business and IT divisions of the organization. Ability to define requirements and prepare and maintain detailed product/project plans and related financial analysis. Demonstrated ability to positively interact with clients, and staff of all levels, a willingness to take accountability for achieving service commitments and a demonstrated ability to achieve results.
Demonstrates ability to appear for work on time, follow directions from a supervisor, interact well with co-workers, understand and follow work rules and procedures, comply with corporate policies, goals and objectives, accept constructive criticism, establish goals and objectives, and exhibit initiative and commitment.
Reasoning Ability
Ability to define problems, collect data, establish facts, and draw valid conclusions. Ability to interpret an extensive variety of technical instructions in mathematical or diagram form and deal with several abstract and concrete variables.
Mathematical Skills
Ability to work with mathematical concepts necessary to assess product costs and recommend pricing algorithms.Ability to apply concepts such as fractions, percentages, ratios, and proportions to practical situations.
Language Skills
Ability to read, analyze, and interpret general business periodicals, professional journals, technical procedures, legal documents, or governmental regulations. Ability to write reports, business correspondence, and procedure manuals. Ability to effectively present information and respond to questions from groups of managers, clients, customers, and the general public.
Competencies
To perform the job successfully, an individual should demonstrate the following competencies:
Analytical - Synthesizes complex or diverse information; Collects and researches data; Uses intuition and experience to complement data; Designs workflows and procedures.
Design - Generates creative solutions; Translates concepts and information into images; Uses feedback to modify designs; Demonstrates attention to detail.
Problem Solving - Analyzes problems logically to identify root causes, seeks input from a wide range of sources, asks insightful questions and formulates effective solutions.
Planning - Produces realistic, effective plans with clear actions and objectives, workable timelines and specific methods to measure progress, taking into account overall goals, required resources and potential obstacles.
Technical Skills - Assesses own strengths and weaknesses; Pursues training and development opportunities; Strives to continuously build knowledge and skills; Shares expertise with others.
Business Knowledge - Demonstrates clear understanding of the nature of the business -- its products and services, goals, market, competitors, and challenges.
Interpersonal Skills - Focuses on solving conflict, not blaming; Maintains confidentiality; Listens to others without interrupting; Keeps emotions under control; Remains open to others' ideas and tries new things.
Communication - Expresses self clearly and effectively in face-to-face interactions, presentations, and written documents, and employs active listening skills to ensure productive interactions.
Responsiveness - Responds promptly, appropriately, and effectively to requests, feedback, and new developments, making sure that all relevant concerns and requirements are understood and addressed.
Interpersonal Effectiveness - Demonstrates good people skills by showing a commitment to teamwork, resolving conflicts effectively and with respect for others’ viewpoints, respecting differences and building strong relationships and networks.
Professionalism - Approaches others in a tactful manner; Reacts well under pressure; Treats others with respect and consideration regardless of their status or position; Accepts responsibility for own actions; Follows through on commitments.
Adaptability - Adapts to changes in the work environment; Manages competing demands; Changes approach or method to best fit the situation; Able to deal with frequent change, delays, or unexpected events.
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 accommodations 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; use hands to finger, handle, or feel; reach with hands and arms and talk or hear. The employee is occasionally required to stand and walk. The employee must occasionally lift and/or move up to 10 pounds. Specific vision abilities required by this job include close vision, distance vision and ability to adjust focus.
Work Environment
The work environment characteristics described here are representative of those an employee encounters while performing the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.
While performing the duties of this job, the employee is in an office setting and is exposed to moderate noise (examples: business office with computers and printers, light traffic).
Working Hours
This is an exempt level position requiring one to work the hours needed to get the job done. Therefore, one must have the flexibility to work beyond traditional hours and be able to work late evenings, weekends and/or on holidays as required to support clients and to work with teams in different time zones. This may be changed from time to time to meet the needs of the business. Typical core business hours are Monday through Friday from 8:00 AM to 5:00 PM PST.
Travel
This position requires limited travel and attendance may be required at various local training sessions and/or meetings.
The Perks:
- 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.
Equal Opportunity Employer, Male/Female/Disabilities/Veterans
OSHA/ADA:
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.
Disclaimer:
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.
