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.
JOB SUMMARY & RESPONSIBILITIES
The essential functions of Formulary Analysts include fulfilling basic to moderately complex formulary set-ups and change requests, researching formulary related questions, documenting basic formulary design specifications, testing and validating formulary setups, and providing formulary related support to clients. Serve as a contact resource between abarca health and Clients, as well as participate in formulary administration decisions with Client Account Management, Implementation and Clinical groups based on criteria established by the department.
Responsibilities include but are not limited to:
• Facilitate the review, analysis, submission of new pharmacy formulary designs for approval to the appropriate decision maker (internal/external) and set-up of the approved formulary designs into RxPlatform.
• Coordinate and lead formulary design reviews with internal and external Clients to ensure accurate set up of pharmacy formularies.
• Manage review of all pharmacy formulary test claims to validate formularies are set up to charge the correct pharmacy cost share which impacts patients and Clients
• Assist in the review of pharmacy formulary audits from the PBMs and assist in any remediation.
• Assist in coordinate all required documentation for compliance with stated Policy and Procedures of department
• Help with RFIs and RFPs when formulary data is required.
• Act as a support resource to the client while participating as a member of the formulary team.
• Support development & maintenance of documentation for formulary education and training purposes.
REQUIRED PROFESSIONAL EXPERIENCE & PROFESSIONAL COMPETENCIES
• Business or healthcare-related Bachelor’s degree or minimum five years’ previous experience in in PBM industry and operations.
• Working knowledge of group benefits, services, and programs. Expanded benefits/insurance industry knowledge through experience and/or coursework preferred.
• Strong problem solving and analytical skills.
• Good technical communication skills, including the ability to write clearly and succinctly so requirements, expectations, results and conclusions readily.
• Organizational and time management skills (to prioritize workloads and meet time sensitive deadlines required).
• Results-oriented with the ability to change priorities as needed.
• Professional presence and business acumen to effectively manage clients, prospects, partners, and vendors.
REQUIRED EDUCATION, TRAINING & LICENSURE/CERTIFICATIONS
• Previous experience with established PBM Technology Companies to maximize our reach in the industry
• Pharmacy Technician License preferred but not required.
• Proficiency with basic statistics and management reporting
• Strong technical capabilities and proficiency, especially using the Microsoft Office Suite (Word, Excel, PowerPoint, and Outlook)
• Advanced education, a plus but not required
• Experience with Medicare Part D regulations is preferred
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.