Senior Pharmacy Analyst - Utilization Management - Fulltime

GENERAL SUMMARY:The Senior Pharmacy Analyst supports the operations of the Pharmacy Care Management Dept. by working on a variety of assigned projects, reports, audits, policies and procedures. This individual also serves as an expert resource on related pharmacy benefit management issues to both departmental co-workers and others within the organization and as a key contact to related external customers and vendors. May be dedicated to primarily supporting a specific product line such as Medicare or Commercial.PRINCIPAL DUTIES AND RESPONSIBILITIES:Collects and reports data to ensure compliance with internal policies and external regulatory requirements such as Medicare, NCQA, state and federal. Assists with audits.Develops, documents and maintains departmental policies, procedures, manuals and databases.Completes assigned tasks required for the efficient and cost-effective operation of the department (e.g. coordinate mailings, formulary updates, rebate processing, excluded provider letters, transitions, member key changes, MAC pricing, support of coverage determination procedures, etc.).Researches and troubleshoots complex pharmacy benefit issues for members, pharmacies, physicians and management.Develops expertise in a particular product line such as Medicare or Commercial and serves as a resource for staff.Produces assigned departmental reports on schedule.Trains employees on pharmacy benefit procedures and policies.Other duties as assigned.KNOWLEDGE, SKILLS AND ABILITIES REQUIRED:One year of pharmacy benefit management or managed care experience required.Two years of pharmacy technician experience or the equivalent required.Excellent organizational skills that facilitate accurate and timely completion of duties.High School Diploma or GED required; Associates Degree is preferred.Additional Information:Organization: Community Care ServicesShift: Day JobUnion Code: Not ApplicableThis posting represents the major duties, responsibilities, and authorities of this job, and is not intended to be a complete list of all tasks and functions. It should be understood, therefore, that incumbents may be asked to perform job-related duties beyond those explicitly described above.

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