Account Specialist, Pharmacy Services
About The Position
Provides support for pharmacy related activities including data analysis, audit and compliance oversight of pharmacy related policies, procedures and processes. Contributes to overarching pharmacy strategy for optimization of medication related health care outcomes, and quality cost-effective member care. Essential Job Duties Collaborates with departments to secure data and analysis necessary to support state reporting, Pharmacy Benefit Manager (PBM) and delegation oversight (both internal and external). Supports and completes all audits as required (SOX, Centers for Medicare and Medicaid Services (CMS), internal, network, etc.) Assists management by preparing and analyzing compliance/audit reports. Assists in the implementation and oversight of processes, policies and procedures. Prepares, researches, and validates information for both internal and external program audits.
Requirements
- At least 2 years of experience in a pharmacy, Pharmacy Benefit Manager(PBM), and/or managed care setting, or equivalent combination of relevant education and experience.
- Certified Pharmacy Technician (CPhT) and/or state pharmacy technician license (state specific if state required). If licensed, license must be active and unrestricted in state of practice.
- Ability to build positive and effective work relationships with coworkers, clients, members, providers, regulatory agencies, and vendors.
- Ability to meet established deadlines.
- Ability to function independently and manage multiple projects.
- Ability to present ideas and information concisely to varied audiences.
- Strong written and verbal communication skills.
- Microsoft Office suite/applicable software program(s) proficiency.
Nice To Haves
- Experience executing Pharmacy Benefit Manager(PBM) and specialty pharmacy contracts on behalf of large payers.
Responsibilities
- Collaborates with departments to secure data and analysis necessary to support state reporting, Pharmacy Benefit Manager (PBM) and delegation oversight (both internal and external).
- Supports and completes all audits as required (SOX, Centers for Medicare and Medicaid Services (CMS), internal, network, etc.)
- Assists management by preparing and analyzing compliance/audit reports.
- Assists in the implementation and oversight of processes, policies and procedures.
- Prepares, researches, and validates information for both internal and external program audits.
Benefits
- Molina Healthcare offers a competitive benefits and compensation package.
- Molina Healthcare is an Equal Opportunity Employer (EOE) M/F/D/V.
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What This Job Offers
Job Type
Full-time
Career Level
Entry Level
Education Level
No Education Listed
