Senior Pharmacy Analyst - Utilization Management - Fulltime
🔍 Troy, Michigan
GENERAL SUMMARY:
The Senior Pharmacy Analyst supports the operations 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 Details
This 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.
Overview
Henry Ford Health partners with millions of people on their health journey, across Michigan and around the world. We offer a full continuum of services – from primary and preventative care to complex and specialty care, health insurance, a full suite of home health offerings, virtual care, pharmacy, eye care and other health care retail. With former Ascension southeast Michigan and Flint region locations now part of our team, Henry Ford’s care is available in 13 hospitals and hundreds of ambulatory care locations. Based in Detroit, Henry Ford is one of the nation’s most respected academic medical centers and is leading the Future of Health: Detroit, a $3 billion investment anchored by a reimagined Henry Ford academic healthcare campus. Learn more at henryford.com/careers.
Benefits
The health and overall well-being of our team members is our priority. That’s why we offer support in the various components of our team’s well-being: physical, emotional, social, financial and spiritual. Our Total Rewards program includes competitive health plan options, with three consumer-driven health plans (CDHPs), a PPO plan and an HMO plan. Our team members enjoy a number of additional benefits, ranging from dental and eye care coverage to tuition assistance, family forming benefits, discounts to dozens of businesses and more. Employees classified as contingent status are not eligible for benefits.
Equal Employment Opportunity/Affirmative Action Employer
Equal Employment Opportunity / Affirmative Action Employer Henry Ford Health is
committed to the hiring, advancement and fair treatment of all individuals without regard to
race, color, creed, religion, age, sex, national origin, disability, veteran status, size, height,
weight, marital status, family status, gender identity, sexual orientation, and genetic information,
or any other protected status in accordance with applicable federal and state laws.