Req #:
1573

Job ID:
13142

Job Location:
New York, NY

Zip Code:
10040

Category:
Pharmacy Services

Agency:
Elderplan

Status:
Regular Full-Time

Office:
Office-based

Salary:
$61,463.13 - $73,755.75 per year
The challenges of affordable healthcare continue to create new opportunities. Elderplan and HomeFirst, our Medicare and Medicaid managed care health plans, are outstanding examples of how we are expanding services in response to our patients' and members' needs. These high-quality healthcare plans are designed to help keep people independent and living life on their own terms.
Why work for MJHS?:

When you work with us you will receive comprehensive and affordable health and financial benefits, in addition to generous paid vacation, personal and holiday time that you won't find at our competitors. Do you receive a paid day off for your birthday now? No? You will here! You will also receive the training, tuition assistance and career development you desire to help you achieve your career goals. You take care of our patients, residents and health plan members, and we will take care of the rest!
Benefits include:

• Tuition Reimbursement for all full and part-time staff
• Generous paid time off
• Affordable medical, dental and vision coverage for employee and family members
• Two retirement plans ! 403(b) AND Employer Paid Pension
• Flexible spending
• And MORE!

MJHS companies are qualified employers under the Federal Government's Paid Student Loan Forgiveness Program (PSLF)

Responsibilities:

The Pharmacy Specialist will perform duties to support the efforts of Elderplan Pharmacy Department in the development, coordination, and maintenance of the plan's pharmacy program. These duties involve administrative tasks and outreach calls to members, providers, and pharmacies as directed by the supervisor. Reviews and identifies opportunities for FWA (fraud, waste, and abuse) control through a review of high-cost drug claims as directed by pharmacists. All outreach activities, documents and reporting requirements are prepared and conducted in a professional and well-coordinated manner to comply with all Part D regulations and guidance.

Qualifications:

• Bachelor's degree required
• 1-2 years experience of general office or administrative, pharmacy and/or pharmaceutical managed care or insurance environment
• 1-3 years of experience in analyzing pharmacy claims data to identify trends and summarize outcomes, Knowledge of Part D regulations, PBM and Star Quality measures for Medicare is strongly preferred.
• Strong interpersonal and organizational skills
• Bilingual English/Spanish a plus
• Excellent written and verbal communication skills
• Proficiency Excel, Word, Visio required
• Experience in Medicare, Medicaid and/or Pharmacy retail strongly preferred