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Pharmacy Benefits

Charlotte, NC
Pharmacy Benefits
Charlotte NC or Fully Remote

Fully Remote/WFH and equipment will be provided.

Position Summary
  • Provide operational expertise to support the team responsible for analyzing client requests, benefits coding.
  • Work alongside our implementation Management team to deliver high quality support to the client.
  • Follow policies and best practices relating to the job function by analyzing client requests, determine the best operational approach and install adjudication related drug lists (eg formulary, clinical edits, plan coverage, etc) in Rxclaim.
  • Ability to collaborate regularly with team to audit, review and verify drug list coding and testing while utilizing various tools
  • Provide SME oversight of operational issues and identify solutions to resolve process issues and operational gaps.
  • Support urgent issues not limited to research and analysis of drug lists setup.
  • Maintain oversight of all implementations/changes ensuring team meets all turnaround time and performance guarantees with excellent quality

Required Qualifications
  • 1-2 years of direct work experience with PBM knowledge
  • Proficient use Microsoft Office applications, e.g. Excel, Word
  • Experience with RxCLAIM and SalesForce Required
  • Experience with data mining large data-sets and critically analyzing for trends and accuracy
  • Auditing experience
  • Able to serve in indirect leadership role and effectively communicate with team and leadership
  • Able to apply logical thinking and analytical skills to research claims issues, formulate a strategic approach and then execute
  • Able to seek out and find solutions independently

Sweta N
Sr. Technical Recruiter
Reqroute Inc,
Email: Sweta@reqroute.com
Phone: 408-600-2007 Extn: 1015

Companies across U.S. have engaged ReqRoute, Inc to deliver skilled, dedicated IT professionals. Recruiting is our passion and we support Fortune 1000 companies with their hiring needs. We always seek to deliver competitive and sought-after career opportunities to our potential consultants and employees. We invite you to review the position requirements and apply today if your skills match our needs.  
ReqRoute, Inc is an Equal Opportunity Employer. Qualified applicants will receive consideration for employment without regard to race, color, religion, sex, age, disability, military status, national origin or any other characteristic protected under federal, state, or applicable local law. (www.reqroute.com)

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