Why you’ll love it here
We are abarca health, a fast-growing PBM and Health Information Technology Company that provides solutions to help our clients lower their costs, improve their services, and streamline their operations. At the core of our industry advantage is our proprietary PBM platform, which is a first-rate SaaS offering. We state this while keeping in mind that any and all of our success is due to our people’s drive and commitment to being “all in”, a quality that is part of the Abarcan DNA and an essential element for us to continue being a distinctive organization that adds significant value to our awesome clients and all of us who work here.
Do you have the Abarcan DNA? Here, you’ll forget half-measures, wholly commit to your passion for delivering the best service, get a chance to do things differently, and all while being part of an industry leader. We’ll be open from the get-go: if “hands-on” and “devoted” are not your work style, then we are better off as ships passing in the night.
What you’ll do
In a few words…
Get to know the benefits of being our Clinical Pharmacist of Government Programs! In this role, you will be responsible for overall clinical operational build, maintenance, submission and updates of formularies and medication list.
The fundamentals for the job…
• To warm up, you will develop and implement Medicare, Medicaid and Exchange formulary programs.
• Provide support and information related to government formulary requirements to clients and internal partners.
• Work collaboratively with other department to operationalize formularies and medication list.
• Work collaboratively with clients and clinical account managers to assist in design of custom formularies.
• Actively participate in government and internal audits.
• Conduct market research to maintain up-to-date on emerging formulary trends.
• Support CMS Medicare STAR initiatives and clinical programs.
• Actively participate in Pharmacy & Therapeutics Committee, prepare presentations and clinical recommendations.
• Overseeing and participating in clinical decision making for prior authorization (PA) and coverage determinations (only physicians and pharmacists may issue clinical denials).
• Continuously looking for ways to streamline and improve the quality of the formulary management process.
• Working with cross functional teams to plan and execute clinical projects and to deliver the highest quality of service for all clients and partners.
• All in all, the role requires putting your best foot forward for the benefit of all our processes. In a timely manner, for sure.
What you’re made of
The bold requirements…
• Bachelor’s or Doctoral Degree in Pharmacy and a current/active Pharmacy License.
• We’ll be very swayed (meaning it’s a big plus) if you already have a strong understanding of Formulary Management, PBM Clinical Operations, and Government program experience (i.e Medicare, Medicaid, Exchange).
• Computer proficiency (of course this is a must), knowledge of Microsoft Office products (you can at least stand your ground while using them), and Internet experience (who doesn’t know how to use the Internet expertly these days? Well, whoever they are, you definitely don’t fall within their ranks).
• You’re great critical thinking (as a benefit implementation analyst of any stripe). You know what it means to be a “share the credit take responsibility” worker. You ride change like an expert surfer rides waves. And let’s not forget your top-rated presentation skills!
• Must be able to communicate effectively (read, write, speak, daydream, argue, flatter, retort wittily etc.) in English.
• Spanish is a plus.
That something extra we´d love to see…
• Analytical: You value the power of context & enjoy examining the past. You get the present by analyzing (sometimes over-analyzing) events leading up to it. This methodology is super helpful, but can provoke analysis-fatigue in those within earshot. Good thing you’re aware of this.
• Motivator: Make the max out of anything and focus on strengths as a way to stimulate personal and group excellence. They seek to transform something strong into something superb. These are the people that say things like “the impossible just takes a little bit longer”.
• Detailed: Nothing gets by you and you rarely forget a thing. When learning some new procedure, you’re the type to take notes. When everyone else is still lost, you’re already at the next steps. Others count on this skill of yours. Maybe due to your detailed nature, you are also exquisitely good at planning. You like to make plans and follow through, meticulously.
• Fixer / Problem solver: You like to provide comprehensive solutions, keeping in mind both internal and external needs. You keep with the mantra of always being part of the solution (not the precipitate). Those who precipitate, you’ve learned, repent at leisure.
• Leader / Mentor: Sincerely and deeply concerned for the professional success of their team. You advise, counsel, guide, teach, preach and overreach. Your heart is true. It’s expected that others will disappoint you.
It is the policy of Abarca Health, LLC, its affiliates and subsidiaries (“Abarca”), to provide equal employment opportunities (EEO) to all employees and applicants for employment without regard to race, color, religion, sex, national origin, age, disability, genetics, or any other characteristic protected by federal, state or local law. In addition,. In addition to federal law requirements, Abarca complies with applicable state and local laws governing nondiscrimination in employment in every location in which the company has facilities. This policy applies to all terms and conditions of employment, including recruiting, hiring, placement, promotion, termination, layoff, recall, transfer, leaves of absence, compensation and training.
Abarca expressly prohibits any form of workplace harassment based on race, color, religion, gender, sexual orientation, gender identity or expression, national origin, age, genetic information, disability, or veteran status. Improper interference with the ability of Abarca’s employees to perform their job duties may result in discipline up to and including discharge.