PBM Contract Operations Analyst

Navitus Health Solutions, LLC; United States; Remote; USD 60,000 - 73,000; Full time

Benefits offered by this job

Health insurance

Dental insurance

Vision insurance

Paid time off

Parental leave (4 weeks)

Job summary

Lumicera is seeking an Analyst, Contract Operations to join the team. The role focuses on operational aspects of Lumicera’s discount programs, including contract compliance with manufacturers and third parties, contract optimization, reconciliation, reporting, and RFP support.

The ideal candidate will have PBM and rebate analytics experience, plus a background in managed care or pharmaceuticals. This is a remote US-based opportunity with a strong benefits package and growth potential.

Qualifications

• Bachelor’s degree required.
• Pharmacy technician license preferred.
• 3-5 years of managed care/pharmacy benefits management or pharmaceutical experience requested.
• Pharmacy technician, trade, Industry Relations, and/or analytical experience preferred.
• Participate in and support compliance program objectives.
• Ability to interact cooperatively and respectfully with other employees.

Responsibilities

• Understand contract design and pricing potentials for client setups.
• Analyze claims data for contract processing accuracy and make recommendations.
• Provide sales and RFP support; work with Finance and Underwriting to assess contracts and pricing risk.
• Support contract review, data entry, evaluation, and reconciliation of client guarantees.
• Serve as a contact for client reporting, questions, and data analysis.

Skills

3-5 years of managed care/pharmacy PBM

Pharmacy technician license preferred

Analytical skills

Team collaboration

Education

Bachelor’s degree

Job description

Company

Lumicera

About Us

Lumicera - Lumicera Health Services Powered by Navitus - Innovative Specialty Pharmacy Solutions- Lumicera Health Services is defining the “new norm” in specialty pharmacy to optimize patient well-being through our core principles of transparency and stewardship. Here at Lumicera, our team members work in an environment that celebrates creativity and fosters diversity. ._____________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________ Current associates must use SSO login option at https://employees-navitus.icims.com/ to be considered for internal opportunities. ______________________We are committed to providing equal employment opportunity to all applicants and employees and comply with all applicable nondiscrimination regulations, including those related to protected veterans and individuals with disabilities. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, national origin, or handicap.

Pay Range

USD $60,214.30 - USD $72,547.34 /Yr.

STAR Bonus % (At Risk Maximum)

7.50 - Salaried Non-Management except pharmacists

Work Schedule Description (e.g. M-F 8am to 5pm)

M-F 8am to 5pm

Remote Work Notification

ATTENTION: Lumicera is only able to offer remote work to residents of Arizona, Alabama, Arkansas, California, Colorado, Florida, Georgia, Illinois, Indiana, Iowa, Louisiana, Maryland, Michigan, Minnesota, Missouri, Nebraska, Nevada, New Jersey, New York, North Carolina, Ohio, Oklahoma, Oregon, Pennsylvania, Tennessee, Texas, Utah, Virginia, Washington, Wisconsin

Overview

Due to growth, we are adding an Analyst, Contract Operations to our team.

The ideal candidate for this position will have experience with PBM's and rebate analytics.

The Analyst, Contract Operations is responsible foroperational aspects of Lumicera’s discount programs including, but not limited to contract compliance through direct pharmaceutical manufacturers, third party entities, contract optimization, contract reconciliation and reporting, sales and request for proposal (RFP) support, internal and external audit support, and client operations.

Is this you? Find out more below!

Responsibilities

How do I make an impact on my team?

• Understand plan formulary design and contracting potentials for client specific set ups.
• Analyze claims data to ensure the accuracy of contract processing, direct contracts with pharmaceutical manufacturers, and establish recommendations to clients for contract optimization.
• Provide sales and request for proposal (RFP) support for prospective clients, client renewals, and market checks. Work closely with the Lumicera Finance and Underwriting teams to assist with evaluating contracts and manage risk in pricing.
• Support contract review, data entry, evaluation, and reconciliation of Lumicera client contract financial guarantees.
• Understand the department and customer business needs and facilitate successful delivery of information for decision-making.
• Serve as direct contact for Lumicera Client Services attending client calls as needed regarding client specific contract reporting, guarantee questions, and data analysis.
• Coordinate with Analytics on the maintenance of the Lumicera Contract reporting environments. Assist in managing new contract program initiatives and the expansion of contract forecasting.
• Serve as the Lumiceraa representative and subject matter expert for Lumicera audits, to include internal, external, manufacturer, client, and regulatory program audits.
• Lead and coordinate Government-related or regulated reporting for internal use and client requirements.
• Review Discount strategy and pharmaceutical manufacturer contracts to accurately set up and maintain parameters in the contract processing system, and correctly allocate payments.
• Other duties as assigned.

Qualifications

Whatourteamexpectsfrom you?

• Bachelor’s degree required.
• Pharmacy technician license preferred.
• 3-5 years of managed care/pharmacy benefits management or pharmaceutical experience required.
• Pharmacy technician, trade, Industry Relations, and/or analytical experience preferred.
• Participate in, adhere to, and support compliance program objectives.
• The ability to consistently interact cooperatively and respectfully with other employees.

What can you expect from Lumicera?

• Top of the industry benefits for Health, Dental, and Vision insurance
• 20 days paid time off
• 4 weeks paid parental leave
• 9 paid holidays
• 401K company match of up to 5% - No vesting requirement
• Adoption Assistance Program
• Flexible Spending Account
• Educational Assistance Plan and Professional Membership assistance
• Referral Bonus Program – up to $750!

#LI-Remote

Location : Address

Remote

Location : Country

US