Pharmacy Administration Specialist - Temporary
Posted on: November 16, 2021
Looking for a way to make an impact and help people?
Join PacificSource and help our members access quality, affordable
PacificSource is an equal opportunity employer. All qualified
applicants will receive consideration for employment without regard
to status as a protected veteran or a qualified individual with a
disability, or other protected status, such as race, religion,
color, national origin, sex, sexual orientation, gender identity or
Diversity and Inclusion: PacificSource values the diversity of the
people we hire and serve. We are committed to creating a diverse
environment and fostering a workplace in which individual
differences are appreciated, respected and responded to in ways
that fully develop and utilize each person's talents and
This role is a temporary position, expected to be till
Position Overview: Collaboratively develop solutions to
departmental strategic and operational requirements. Support all
aspects of the pharmacy benefit and work with the Pharmacy team on
implementing, and coordinating pharmacy initiatives, including
compliance and 5-Star goals. Act as a liaison and information
resource to internal and external pharmacy services customers.
Manage communications, develop policies and procedures, and
generate and review reports to ensure departmental compliance
according to PacificSource and regulatory standards. Support
department vision by demonstrating effective teamwork, managing
change, and encouraging innovation and staff involvement.
- Process incoming reports from Centers for Medicare & Medicaid
Services (CMS), Oregon Health Authority (OHA) and Prescription
Benefit Manager (PBM) take action as needed.
- Support administrative aspects of 5 Star initiatives through
mailings, report generation, and other tasks as assigned.
- Maintain member, pharmacy and provider communications current
with compliance guidance and industry best practices.
- Support the maintenance of the pharmacy benefit formulary
across lines of business.
- Maintain website formulary and coverage policies in compliance
with CMS timelines and regulations.
- Work with Product Development and Pharmacy teams to ensure
accurate and optimal pharmacy benefit designs.
- Serve as an inter-departmental liaison for benefit
configuration and testing.
- Provide oversight of PBM operations through the following
actions: attending meetings; review and approve external
communications; and monitor operational performance.
- Research and document PBM Service Warranties Develop Pharmacy
department policies & procedures as applicable and ensure regular
maintenance to reflect new practices and guidance.
- Support Compliance and departmental monitoring, oversight, and
audits in the following areas: CDAG, ODAG, CDE, OIG, NCQA;
oversight of PBM, MTM and other vendors; and review of technician
documentation, coverage decisions and call monitoring.
- Support Fraud, Waste, and Abuse (FWA) efforts by identifying
cases, conducting preliminary research, and interfacing with the
FWA team about findings.
- Facilitate pharmacy department training and documentation of
- Facilitate inter-departmental communications about policies,
procedures, or operational changes
- Generate pharmacy claims reports and dashboards to support
other administrative initiatives as directed.
- Meet department and company performance and attendance
regulations concerning confidentiality and security of protected
- Perform other duties as assigned.
Work Experience: Minimum of two years of pharmacy related health
insurance experience required.
Education, Certificates, Licenses: High school diploma or
equivalent required. Bachelor's degree preferred. Pharmacy
Technician Certification required.
Knowledge: Strong computer skills. Excellent verbal and business
writing skills. Excellent public relations skills. Good
understanding of Medical Terminology required. Requires ability to
define and prioritize problems and manage workload without direct
- Building Customer Loyalty
- Building Strategic Work Relationships
- Building Trust
- Continuous Improvement
- Contributing to Team Success
- Planning and Organizing
- Work Standards
Environment: Work inside in a general office setting with
ergonomically configured equipment. Travel is required
approximately 10% of the time.
We live and breathe our values. In fact, our culture is driven by
these seven core values which guide us in how we do business:
- We are committed to doing the right thing.
- We are one team working toward a common goal.
- We are each responsible for customer service.
- We practice open communication at all levels of the company to
foster individual, team and company growth.
- We actively participate in efforts to improve our many
communities-internally and externally.
- We actively work to advance social justice, equity, diversity
and inclusion in our workplace, the healthcare system and
- We encourage creativity, innovation, and the pursuit of
Physical Requirements: Stoop and bend. Sit and/or stand for
extended periods of time while performing core job functions.
Repetitive motions to include typing, sorting and filing. Light
lifting and carrying of files and business materials. Ability to
read and comprehend both written and spoken English. Communicate
clearly and effectively.
Disclaimer: This job description indicates the general nature and
level of work performed by employees within this position and is
subject to change. It is not designed to contain or be interpreted
as a comprehensive list of all duties, responsibilities, and
qualifications required of employees assigned to this position.
Employment remains AT-WILL at all times.
Keywords: PacificSource, Salem , Pharmacy Administration Specialist - Temporary, Healthcare , Salem, Oregon
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