Pharmacy Analyst

Job Title: Pharmacy Analyst

Why work at OpTech?

OpTech is a woman-owned company that values your ideas, encourages your growth, and always has your back. When you work at OpTech, not only do you get health and dental benefits on the first day of employment, but you also have training opportunities, flexible/remote work options, growth opportunities, 401K and competitive pay. Apply today! To view our complete list of openings, please visit our website at www.optechus.com.

Responsibilities/Tasks:

• Assist with all functions related to Pharmacy Benefit Manager (PBM) oversight for Medicare Advantage Part D plans.

• Receive and respond to plan related member and provider inquires.

• Troubleshoot problems, inquiries, and provide timely response.

• Works with internal and external partners to ensure compliance with CMS regulations.

• Performs routine tracking, auditing, and reporting of performance in relation to CMS requirements.

• Supports the organization in the event of an internal or external audit.

• Coordinate review of Part D member and provider communications.

• Recommends and assists with development of policies and procedures and desk level guides.

• Assists personnel (both internal and external) by answering questions, supplying information, and maintaining metric and performance dashboards.

• Assist in monitoring reports to track operational effectiveness and vendor service levels.

• Report reconciliation in multiple software environments.

• Proficiency with and responsibly for pulling data reports from readily available databases and reporting tool.

• Maintain drug lists and HCPCs changes or updates.

• Perform other related duties as assigned.

QUALIFICATIONS:

Top 3 Required Skills/Experience:

• Retail Pharmacy, Healthplan, PBM or related experience - at least 2 years

• Strong computer skills and use of existing software packages (Excel, Power Point, Word, Outlook, etc.)

• Knowledge of claims processing and prescription drug names

o Required Skills/Experience

• Detail Oriented

• Organization and time management skills, as evidenced by the capacity to prioritize multiple tasks and job duties/responsibilities.

• Capability to work independently and efficiently complete tasks in a fast-paced environment.

• Ability to read and interpret process workflows.

• Strong interpersonal communication skills and experience with interacting across multiple departments.

o Preferred Skills/Experience:

• CMS Part D knowledge & CMS regulations

• Knowledge of PBM systems and tools

• Healthplan experience

o Education/Certifications:

• CPhT preferred (Certified Pharmacy Tech licensed)
• High school diploma or GED

OpTech is an equal opportunity employer and is committed to creating a diverse environment. All qualified applicants will receive consideration for employment without regard to race, color, religion, gender, gender identity or expression, sexual orientation, national origin, genetics, pregnancy, status as a parent, disability, age, veteran status, or other characteristics as defined by federal, state or local laws. https://www.optechus.com/eeo_self_identification/

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