What are the responsibilities and job description for the Specialty Pharmacy Solutions Expert position at AscellaHealth?
About the Role
As a Government Pharmacy Programs Manager at AscellaHealth, you will oversee the day-to-day Medicare Part D support for our clients and internal team members. This includes conducting end-to-end testing and review of accurate claim processing according to CMS guidelines and Plan Benefit Design.
We are seeking a dedicated and passionate individual to join our team as a Government Programs Manager. The ideal candidate will have three (3) years of experience in a quality assurance, audit, or program management role, preferably with certification in pharmacy technology or equivalent experience.
The selected candidate will perform quality inspections and audits, assist with problem-solving of client and program issues, and conduct necessary training. They will also be responsible for supporting efforts to design, develop, implement, and oversee various Medicare Part D processes that support both regulatory requirements and client expectations.
- Analyze Daily Program Reporting: Ensure program oversight and compliance with CMS guidance by analyzing daily program reporting and claim processor adjudication data.
- Audit Support: Provide audit support, including client audits and/or CMS audits, to ensure accuracy and adherence to regulatory requirements.
- Create Accurate Reports: Develop and maintain accurate and timely internal and client reporting to support business decisions and process improvements.
- Serve as Subject Matter Expert: Serve as a subject matter expert for the business processes related to quality management and improvement.
- Develop Test Scenarios: Develop and maintain pre-implementation and post-implementation claim test scenarios to ensure system accuracy and functionality.
- Client and Vendor Support: Assist with providing client and vendor support, ensuring effective communication and issue resolution.
