What are the responsibilities and job description for the PLAN ANALYST position at ResCare?
Our Company
PharMerica
Overview
The Plan Analyst establishes and sets up pricing and plan parameters in the pharmacy practice systems to support PharMerica client contracts and 3rd party plans. Responsible for the client pricing implementation process and pricing changes, resolving client issues, working in LTC400 and RxExact pharmacy systems for standard and complex plan designs. May work with formularies, the product file, and/or IV setups.
This position offers a Hybrid schedule. Applicants need to reside a commutable distance to Louisville, KY.
Responsibilities
- Maintains client pricing and pharmacy coverage parameters in the pharmacy practice systems
- Conducts research and provide information to internal partners on client pricing and coverage set-up
- Ensures accurate claim processing by correcting and communicating discrepancies found in set-up and/or quality assurance testing and recommends appropriate plan set-up changes and/or system modifications when required
- Analyzes the client request and determine the best operational approach and perform set-up
- Conducts research and provide information to internal partners on client pricing, coverage set up and product file questions
- Provides consultation and expertise to internal partners
- Participates and/or takes the lead in special projects
- Performs other tasks as assigned
- Conducts job responsibilities in accordance with the standards set out in the Companys Code of Business Conduct and Ethics, its policies and procedures, the Corporate Compliance Agreement, applicable federal and state laws, and applicable professional standards
To perform this job successfully, an individual must be able to perform each essential duty satisfactorily. The requirements listed above are representative of the knowledge, skill, and/or ability required. Each essential function is required, although reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.
Qualifications
- Bachelors degree
- Three or more years corporate experience
- Long Term Care, Pharmacy Practice Management System setup, Healthcare Billing, Retail Pharmacy Tech, Insurance and/or PBM experience preferred
- Ability to work with a high degree of accuracy and attention to detail
- Strong interpersonal skills to work effectively with internal customers Microsoft office products
- Knowledge of claims processing system or pharmacy practice system desired
- Strong analytical and critical thinking skills
- Advanced Excel and/or data knowledge
About our Line of Business
PharMerica is a full-service pharmacy solution providing value beyond medication. PharMerica is the long-term care pharmacy services provider of choice for senior living communities, skilled nursing facilities, public health organizations and post-acute care organizations. PharMerica is one of the nation's largest pharmacy companies. PharMerica offers unmatched employee development, exceptional company culture, seemingly endless opportunities for advancement and the highest hiring goals in decades. For more information about PharMerica, please visit www.pharmerica.com. Follow us on Facebook, Twitter, and LinkedIn.
