• Job Description

  Req#: 1898
  Employer Industry: Healthcare Services
  
  Why Consider this Job Opportunity:
  - Competitive compensation and benefits package
  - Annual incentive bonus plan
  - Medical, dental, and vision insurance with low deductible/low cost health plan
  - Generous vacation and sick time accrual
  - 12 paid holidays
  - State Retirement (pension plan)
  - 401(k) Plan with employer match
  - Company paid life and disability insurance
  - Wellness Programs
  - Flexible office location or remote work option available
  - Opportunity for career advancement and growth within the organization
  - Focus on integrated use of data management platforms for predictive analytics
  - Chance to work on population health initiatives and make a meaningful impact
  - Utilize advanced Excel skills and other data systems for analysis and reporting
  
  What to Expect (Job Responsibilities):
  - Serve as a liaison between Partners Health Management, the Pharmacy Benefit Manager (PBM), and State Department of Health Benefits (DHB) for troubleshooting and problem-solving
  - Receive and respond to provider and pharmacy provider calls regarding prior authorization claims status and preferred drug list process
  - Review pharmacy PA utilization and override reporting, track and trend PA and override reporting, and analyze cost and utilization patterns
  - Report complaints and grievances related to the pharmacy provider network
  - Assist with educating community pharmacists and providers on the health plan's pharmacy benefit and clinical policies
  - Analyze data to identify population health needs, extract information for trend analysis and dashboard reports, and maintain resource materials and data files
  
  What is Required (Qualifications):
  - Knowledge in pharmacy practices and procedures, including understanding of state and Federal laws related to pharmacy practice
  - Experience with Microsoft Word and Excel
  - Excellent written and verbal communication skills
  - Ability to analyze and interpret healthcare claims data and tell a meaningful story with data visualization
  - Ability to work on multiple projects simultaneously with minimal supervision
  
  How to Stand Out (Preferred Qualifications):
  - 2 years of experience as an analyst in the healthcare industry with medical claims, membership, and provider data
  - Master's Degree in business administration, data analytics, or related field
  - Current registration with NC State Board of Pharmacy as Pharmacy Technician or eligible and registered within 30 days of hire
  - Current/active National Pharmacy Technician Certification (CPhT)
  
  #HealthcareServices #DataAnalytics #PharmacyTechnician #CareerOpportunity #CompetitivePay
  
  We prioritize candidate privacy and champion equal-opportunity employment. Central to our mission is our partnership with companies that share this commitment. We aim to foster a fair, transparent, and secure hiring environment for all. If you encounter any employer not adhering to these principles, please bring it to our attention immediately.
  We are not the EOR (Employer of Record) for this position. Our role in this specific opportunity is to connect outstanding candidates with a top-tier employer.

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