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FIND YOUR FUTURE

We're excited about the potential people bring to our organization. You can grow your career here while enjoying first-class perks, benefits and a culture that fosters growth, innovation and collaboration.

Overview

The Pharmacy Systems Coordinator is responsible for maintaining all pharmacy systems to allow Pharmacy Benefit Dimensions (PBD) to accurately adjudicate prescription claims against the pharmacy benefits of its members and provide accurate pharmacy information to all stakeholders. Responsibilities include, but are not limited to, benefit designs, claims payment, eligibility issues, researching and resolving inquiries, assist with training associates, and updating documentation for all lines of business. Occasional evenings, weekends, holidays and overtime are a requirement of the position.

Qualifications

+ High School diploma or GED required.

+ Three (3) years of pharmacy experience required. One (1) year of experience as a PBD Pharmacy Systems Assistant may be considered in lieu of three (3) years pharmacy experience requirement.

+ Significant and detailed knowledge and experience with RxClaim™ and associated systems is preferred.

+ Strong interpersonal, written and verbal communication skills.

+ Strong Microsoft Office skills required. Experience with Microsoft Office applications, and demonstrated ability to learn new software application.

+ Experience in report production, and the ability to maximize use of system capabilities to lead the organization in outcome improvement.

+ Proven examples of displaying the PBD values: Trusted Advisor, Innovative, Excellence, Guardianship, Dedication and Caring.

Essential Accountabilities

+ System Administration and Maintenance: Assist with maintenance of RxClaim functionality as it pertains to all lines of business. Attend assigned MOD review meetings, test and/or review SR’s assigned for MOD implementation and assist with installation tasks on MOD night. Communicate problem defects to Pharmacy Systems Specialist along with detailed documentation and associated testing scenarios. Ensure reliable interfacing with the HealthRules system, and other support systems. Responsible for maintenance of the RxAuth application.

+ Benefit and Formulary Administration: Build benefit plans in the RxClaim system to ensure pharmacy claims process according to the design of the product. Responsible for assigned primary or secondary testing for all plan builds or updates, including tests to confirm administration accuracy and consistency. Maintain and follow the documented drug change process for formulary updates within set time frames and with accuracy within the policy. This includes reporting issues or questions to the Pharmacy Systems Specialist. Responsible for the maintenance of all eligibility files for all lines of business, including but not limited to updating person codes, dual eligible members, UOI updates, staging/loading files, and updating monthly eligibility logs. Provide support and assist with process improvements. Participate in any ad-hoc projects as needed.

+ Claims Management and Payment: Responsible for daily review of the payment process in RxClaim, including but not limited to reviewing reports and resolving any associated issues. Monitor and validate claims for processing accuracy. Participate as the Detective of the Day to handle help desk issues. Escalate all unresolved issues to the Pharmacy Systems Specialist. Also responsible for build and testing of new pharmacies, pharmacy pricing and QA-ing client pricing. Complete processing of file loads needed for claims management. Assist with any ad-hoc projects as needed.

+ Training and Documentation: Assist with the creation or revision of all training documentation, policies and procedures. Ensure that documentation accurately reflects system functionality, industry best practices, and are appropriate, current, and well organized. Also accountable for the training and mentoring of associates.

Immigration or work visa sponsorship will not be provided for this position

Hiring Compensation Range: $22.00 - $23.50 hourly

_Compensation may vary based on factors including but not limited to skills, education, location and experience._

In addition to base compensation, associates may be eligible for a scorecard incentive, full range of benefits and generous paid time off. The base salary range is subject to change and may be modified in the future.

_As an Equal Opportunity / Affirmative Action Employer, Independent Health and its affiliates will not discriminate in its employment practices due to an applicant’s race, color, creed, religion, sex (including pregnancy, childbirth or related medical conditions), sexual orientation, gender identity or expression, transgender status, age, national origin, marital status, citizenship and immigration status, physical and mental disability, criminal record, genetic information, predisposition or carrier status, status with respect to receiving public assistance, domestic violence victim status, a disabled, special, recently separated, active duty wartime, campaign badge, Armed Forces service medal veteran, or any other characteristics protected under applicable law._ _Click here (http://www.independenthealth.com/about/careers/additional-eeo-aap-information)_ _for additional EEO/AAP_ _or Reasonable Accommodation_ _information._

Current Associates must apply internally via the Job Hub app.

The Independent Health Family of Companies, headquartered in Buffalo, NY, serves nearly 400,000 members and provides innovative health care products and benefits designed to engage consumers in their health and well-being. Established in 1980, our comprehensive portfolio includes Pharmacy Benefit Dimensions, Reliance Rx, Nova Healthcare Administrators, Care for You and the Independent Health Foundation.

Our culture sets us apart. Our core values drive who we are and the work we do. As a member of our family, you’re part of something special, in your work and in the community.

We understand and appreciate that everyone has unique experiences, perspectives and identities which is why we pledge to create a safe space where all people and ideas are welcomed. We are here to continue learning and to generate important dialog.

We are committed to doing what matters most - reaching out, working together, and caring for our community. A healthy community benefits everyone who lives in it. You too can be part of making difference in the lives of others, together we achieve so much more. Please click here (http://www.independenthealth.com/about/community-report) to view our Community Reports.

Apply today and join us on the journey to a happier, healthier, and more inclusive community.

We are a drug-free workplace. We are committed to providing reasonable accommodations for qualified individuals with disabilities and disabled veterans. An applicant for employment in need of an accommodation to participate in the application and recruitment process should contact Human Resources at: [email protected] or Human Resources, 511 Farber Lakes Drive, Williamsville, NY 14221.

_Please note, we do not accept unsolicited resumes. We do not accept resumes from headhunters, placement agencies, or other suppliers that have not signed a formal agreement with us._