What are the responsibilities and job description for the Associate Formulary Analyst position at Abarca Health?
What you'll do
In a few words...
Abarca is igniting a revolution in healthcare. We built our company on the belief that with smarter technology we are redefining pharmacy benefits, but this is just the beginning...
As an Associate Formulary Analyst, you will be responsible for configuring and implementing formularies across Medicare, Commercial, and Employer clients, including complex setups and process changes.
The fundamentals for the job...
- Execute standard formulary setups for new Medicare, Commercial and Employer client implementations, and process changes for existing clients.
- Perform unit testing to confirm configuration set-up or changes are processing as expected as defined in the client documentation.
- Conduct design review of peers on the proposed build design and configuration peer review.
- Perform Quality Control and Quality Assurance functions to assess information accuracy in all Formulary Management processes.
- Support the research and resolution of adjudication and processing issues including, identification of root cause, impact analysis determination and corrective action.
- Applyappropriate sense of urgency support to other areas to verify and analyze claims processing cases, eligibility, and other operational situations and issues referred for validation within SLAs / SLOs.
- Collaborate and coordinate with other business units to execute configuration asrequired.
- Responsible for daily tracking and monitoring of assigned requests to ensure due dates are met.
- Basic understanding of external regulator guidelines such as Medicare, Medicaid, and state requirements, to make timely adjustments to operations ensuring our processes follow compliance, rules, and regulations.
- Provide feedback on processes and make recommendations for improvements.
- Support analysts in creating new knowledge articles related to formularytopics.
What we expect of you
The bold requirements...
Nice to haves...
Physical requirements...
At Abarca we value and celebrate diversity. Diversity, equity, inclusion, and belonging are guiding principles of Abarca and ensure Abarca's workforce reflects the communities it serves. We are proud to provide equal employment opportunities to all employees and applicants for employment and prohibit discrimination and harassment of any type without regard to race, color, religion, age, sex, national origin, disability status, medical condition, genetic information, protected veteran status, sexual orientation, gender identity or expression, or any other characteristic protected by federal, state, or local laws.
Abarca Health LLC is an equal employment opportunity employer and participates in E-Verify. Abarca Health LLC does not sponsor employment visas at this time.
The above description is not intended to limit the scope of the job or to exclude other duties not mentioned. It is not a final set of specifications for the position. It's simply meant to give readers an idea of what the role entails.
LI-TA #LI-REMOTE
