Pharmacy Analyst IV - Formulary

Medica's Pharmacy Analysts work in conjunction with key internal and external stakeholders to support all clinical pharmacy administrative and operational functions including but not limited to pharmacy formularies, regulatory bid submissions, medical drug policies, utilization management (UM), and Accountable Care Organization (ACO)/quality programs.

Key Accountabilities:

• Serve as a subject matter expert for Qualified Health Plan (QHP) or Medicare bid pharmacy formulary-related file submissions
• Manage pharmacy formulary document production, disruption process, display, and maintenance
• Process Pharmacy Benefit Manager (PBM)/Vendor standard utilization reports
• Implement regulatory driven formulary enhancements with vendor partners
• Monitor and manipulate data to support ACOs and quality improvement (Medicare star performance)
• Write and maintain pharmacy standard clinical operating procedures
• Manage medical drug policies, member letters, and website display
• Act as a liaison to internal specialists for medical drug coding and configuration
• Respond to and/or triage pharmacy customer service inquiries from all customers including members, providers, and internal departments
• Actively participate in internal and external meetings necessary to support key accountabilities
• Educate and promote continuous process improvement opportunities across the enterprise

The individual in this role will ensure that work is done in compliance with applicable state and federal regulations.

It's important that our Pharmacy Analysts have a strong understanding of pharmacy formulary maintenance, medical policy development, regulatory bid submission, and quality improvement processes. This position will need to effectively navigate a large health care organization and understand the unique needs of customers including members, providers, and internal peers.

Qualifications:

• Bachelor's degree in healthcare related field required
• 7+ years of related experience
• Prior experience with a health plan or PBM is preferred
• Experience working in a matrixed or multi-disciplinary environment is preferred

Certifications/Licensure:

• Certified Pharmacy Technician preferred

Skills and Abilities:

• Proficiency with Microsoft Excel
• Organized individual who can simultaneously balance and- execute through multiple projects and priorities
• Self-starter, possessing willingness and ambition to work through ambiguity
• Creative thinker
• Motivated to problem solve
• Collaborative, team-oriented spirit
• Excellent written and verbal communication skills
• Customer/patient focused
• Operates with flexibility in changing business environment
• Proven track record on consistently achieving desired results

This position is a hub-based role which requires onsite presence. To be eligible for consideration, candidates must reside within a commuting distance to one of the following office locations: Minnetonka, MN, Omaha, NE, or Madison, WI. Onsite frequency is determined by business need as decided by leadership and may be up to 2-3 days a week.

The full salary range for this position is $77,100 - $132,200.

Annual salary range placement will depend on a variety of factors including, but not limited to, education, work experience, applicable certifications and/or licensure, the position's scope and responsibility, internal pay equity and external market salary data. In addition to compensation, Medica offers a generous total rewards package that includes competitive medical, dental, vision, PTO, Holidays, paid volunteer time off, 401K contributions, caregiver services and many other benefits to support our employees.

The compensation and benefits information is provided as of the date of this posting. Medica's compensation and benefits are subject to change at any time, with or without notice, subject to applicable law.

We are an Equal Opportunity employer, where all qualified candidates receive consideration for employment indiscriminate of race, religion, ethnicity, national origin, citizenship, gender, gender identity, sexual orientation, age, veteran status, disability, genetic information, or any other protected characteristic.