Hybrid Pharmacy Operations Strategist

Viva Health; Birmingham (AL); Hybrid; USD 70,000 - 90,000; Full time

Benefits offered by this job

Health Insurance

401(k) Plan

Paid Time Off

Holidays & Floating Holiday

Tuition Assistance

Flexible Spending Accounts

Wellness Program

Training and Development

Job summary

Viva Health, a part of UAB Health System, seeks a Pharmacy Operations Analyst in Birmingham, AL to manage pharmacy benefit administration for Commercial and Medicare lines. The role collaborates with PBMs, researches claims issues, and ensures regulatory compliance in a hybrid work setting.

Responsibilities include monitoring PDE acceptance, reporting, and issue resolution, plus maintaining up-to-date process documentation and contributing to audits.

Qualifications

• Bachelor's degree or equivalent experience required.
• 5-7 years’ experience with a Health Plan, Part D, Pharmaceutical Industry, PBM, etc.
• Excellent interpersonal, analytical, and communication skills; experience with audit and PDE reporting preferred.

Responsibilities

• Monitor and report on pharmacy benefit administration activities for Commercial and Medicare lines.
• Collaborate with PBMs to maintain and update pharmacy benefits and resolve claims payment anomalies.
• Produce routine operational dashboards and track PDE acceptance rate, claim rejects, and FIR reporting.
• Support audits and gather documentation, evidence, and corrective actions as needed.
• Assist with escalation handling and documentation of processes and procedures.

Skills

Interpersonal skills

Analytical abilities

Oral and written communication

Public speaking

Education

Bachelor's degree or equivalent experience

Tools

Power Query

Excel

PowerPoint

Word

Job description

Viva Health, a part of UAB Health System, seeks a Pharmacy Operations Analyst in Birmingham, AL to manage pharmacy benefit administration for Commercial and Medicare lines. The role collaborates with PBMs, researches claims issues, and ensures regulatory compliance in a hybrid work setting.

Responsibilities include monitoring PDE acceptance, reporting, and issue resolution, plus maintaining up-to-date process documentation and contributing to audits.