Formulary Admin Specialist I

Requirements

• Education and/or Experience
• Associate's degree or Certified Pharmacy Technician CPT (or equivalent combination of education and experience required). Bachelor's degree preferred. At least 1+ year pharmacy (or) 1+ year PBM industry experience working wi

Benefits

Additional Information

Exemption Status: United States of America (Non-Exempt) $22.99 - $30.35 - $37.71 "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." This position is not eligible for Sponsorship. 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 Essential Duties and Responsibilities include the following. Other duties may be assigned. Weekly Drug Updates for Commercial clients Reviews weekly drug update projects, participate and assist in weekly formulary maintenance Attends Client meetings Monitors/updates Drug Rules and Auto coding rules per client requests Researches and responds to client inquiries; escalates to managers/pharmacists for complex issues Weekly Drug Updates for Medicare Part D formularies. Reviews weekly drug update projects, and participate and assist in weekly formulary maintenance Researches and responds to client inquiries; escalates to managers/pharmacists for complex issues Formulary mailbox and salesforce cases management Triages inquiries; serves as a resource for troubleshooting basic issues; escalates to managers/pharmacists for complex issues Drafts client communication to be reviewed by management; customizes templates with client instructions including clarification of roles/ responsibilities between MedImpact and the client; prepares routine client responses to email and salesforce case queries. Monthly and Pre-Plan Year ASCII Submissions Uploads CMS status tracking and responses, updates version numbers within Formulary Service's database Processes and distributes formulary ASCII submissions files to clients Uploads ASCII files to Health Plan Management System (HPMS)for standard formularies collaborating with the assigned pharmacist; Negative Formulary Changes Process Enters negative formulary changes request into formulary platform tool for standard formularies; Uploads and submits negative changes request into HPMS for Standard formularies; Processes and performs quality control for "Future Formulary Change Files" and distribute to clients for website posting; Formulary Pre-plan Year Process Reviews with the client the Formulary Implementation Questionnaire (IQ) and clarifies any questions/issues; Builds the formulary framework based on the client's implementation questionnaire for review by pharmacists; Prepare basic formulary parameters (rules) into the spreadsheet, this includes "temporary" or "special coding"; Provides audit support for claims analysis and sending client communications Performs Prior Authorization (PA) processing as needed during times of staffing shortages or absences. Works to gain a solid understanding of Formulary and PBM operations through on-the-job training, in-house educational opportunities and related external seminars or coursework. 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).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 client situations.