PBM Network

6 days ago


Daytona Beach, Florida, United States Florida Health Care Plans Full time

PBM Network & Pricing Configuration Analyst

PharmacyFull-time1st shiftPharmacy Operation hours

POSITION SUMMARY

The Pharmacy Benefit Manager Operations and Services team provides high quality services to clients and members by running services from pricing, eligibility, configurations, and beneficiary services to government services and beyond.

As the PBM Network & Pricing Configuration Analyst, you will be responsible for implementing new and updating existing benefit plan setups for Medicare, Commercial, and Employer clients. Also, you will review client configuration requests, identify, and define their needs and requirements, determine the best operational approach, and perform setup in the Pharmacy Benefit Manager System. The position also requires that you perform client configuration setup testing on all plan benefit design changes into a production scenario to ensure proper and accurate configuration for claims processing and adjudication. Additionally, you will provide first level triage for operational issues, analyze, and identify solutions to resolve issues in configuration setup, claims processing and other operational gaps.

QUALIFICATIONS:


• 3+ years of work-related experience.

• Experience applying analytical and troubleshooting skills to claims administration operations.

• Experience working with SQL and Excel tools.

• Ability to establish good interpersonal skills.

• Good oral and written communication skills. 

• Must maintain an active Pharmacy Technician License in the State of Florida.



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