PA Guidelines Specialist

Exemption Status:United States of America (Non-Exempt)

$45,984 - $60,699 - $75,415

“Pay scale information is not necessarily reflective of actual compensation that may be earned, nor a promise of any specific pay for any selected candidate or employee, which is always dependent on actual experience, education, qualifications, and other factors. A full review of our comprehensive pay and benefits will be discussed at the offer stage with the selected candidate.”

This position is not eligible for Sponsorship.

MedImpact Healthcare Systems, Inc. is looking for extraordinary people to join our team!

Why join MedImpact? Because our success is dependent on you; innovative professionals with top notch skills who thrive on opportunity, high performance, and teamwork. We look for individuals who want to work on a team that cares about making a difference in the value of healthcare.

At MedImpact, we deliver leading edge pharmaceutical and technology related solutions that dramatically improve the value of health care. We provide superior outcomes to those we serve through innovative products, systems, and services that provide transparency and promote choice in decision making. Our vision is to set the standard in providing solutions that optimize satisfaction, service, cost, and quality in the healthcare industry. We are the premier Pharmacy Benefits Management solution!

Job Description

Qualifications

To perform this job successfully, an individual must be able to perform each essential duty satisfactorily. The requirements listed below are representative of the knowledge, skill, and/or ability required. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.

Education and/or Experience

Associate's degree (A.A.) or equivalent from two-year College or technical school; or at least two years of related experience and/or training; or equivalent combination of education and experience.

Previous health care, medical or pharmacy experience preferred. Excellent proofreading abilities and a minimum typing speed of 55+ wpm. Able to work independently, with minimal supervision and/or in teams.

Computer Skills

Intermediate knowledge of MS Office/Word, Excel, and Outlook and aptitude for new programs. Experience with Windows based database programs is also required.

Certificates, Licenses, Registrations

Must successfully complete one of the national certification exams OR obtain state licensure (in an U.S. State or Territory). Maintains a current Pharmacy Technician License and/or CPhT certification without restriction.

Other Skills and Abilities

Demonstrates ability to appear for work on time, follow directions from a supervisor, interact well with co-workers, understand and follow work rules and procedures, comply with corporate policies, goals and objectives, accept constructive criticism, establish goals and objectives, and exhibit initiative and commitment.

Understanding of managed pharmacy benefit concepts including formularies, prior authorizations, edits, and claim adjudication. Self-starter with the ability to work independently and as part of a team. Ability to apply common sense understanding to carry out instructions furnished in written, oral, or diagram form. Ability to deal with problems involving several concrete variables in standardized situations.

Reasoning Ability

Ability to apply common sense understanding to carry out detailed but uninvolved written or oral instructions. Ability to deal with problems involving a few concrete variables in standardized situations.

Mathematical Skills

Ability to add, subtract, multiply, and divide in all units of measure, using whole numbers, common fractions, percentages and decimals.

Language Skills

Ability to read and comprehend simple instructions, short correspondence, and memos. Ability to write simple correspondence.  Ability to effectively present information in one-on-one and small group situations to customers, clients, and other employees of the organization.

Competencies

To perform the job successfully, an individual should demonstrate the following competencies:

Business Knowledge - Demonstrates clear understanding of the nature of the business -- its products and services, goals, market, competitors and challenges. 

Customer and Quality Focus - Actively demonstrates a personal concern for understanding client needs, ensuring the quality of products and services, maintains a high level of customer satisfaction, and contributes to continuous improvement of products and processes.

Responsiveness - Responds promptly, appropriately and effectively to requests, feedback and new developments, making sure that all relevant concerns and requirements are understood and addressed.

Problem Solving - Analyzes problems logically to identify root causes, seeks input from a wide range of sources, asks insightful questions and formulates effective solutions.

Communication - Expresses self clearly and effectively in face-to-face interactions, presentations and written documents, and employs active listening skills to ensure productive interactions.

Time Management - Plans effectively to meet target deadlines, foresees delays and responds proactively, sets realistic timetables, utilizes time efficiently, and completes projects on time.

Interpersonal Effectiveness - Demonstrates good people skills by showing a commitment to teamwork, resolving conflicts effectively and with respect for others’ viewpoints, respecting differences and building strong relationships and networks.

Initiative - Proactively gathers and analyzes information, assesses situations and identifies challenges and opportunities, sees what needs to be done and takes appropriate action.

Adaptability - Adjusts quickly to evolving situations by integrating new information, remaining flexible, recognizing and implementing necessary changes and taking advantage of opportunities presented by new developments.

Physical Demands

The physical demands described here are representative of those that must be met by an employee to successfully perform the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.

While performing the duties of this Job, the employee is regularly required to sit; use hands to finger, handle, or feel; reach with hands and arms and talk or hear. The employee is occasionally required to stand and walk. The employee must occasionally lift and/or move up to 10 pounds. Specific vision abilities required by this job include close vision, distance vision and ability to adjust focus.

Work Location

This position works from a remote location.

Working Hours

This is a non-exempt position requiring one to be able to work overtime from time to time in order to get the job done. Therefore, one must have the ability to work nights, weekends or on holidays as required. This may be changed at any time to meet the needs of the business. The typical working hours for this position are Monday through Friday from 8:00 AM to 5:00 PM and may include weekend and Holiday hours.

Travel

This position requires no travel; however, attendance may be required at various local conferences and meetings.

The Perks:

• Medical / Dental / Vision / Wellness Programs
• Paid Time Off / Company Paid Holidays
• Incentive Compensation
• 401K with Company match
• Life and Disability Insurance
• Tuition Reimbursement
• Employee Referral Bonus

To explore all that MedImpact has to offer, and the greatness you can bring to our teams, please submit your resume to www.medimpact.com/careers

MedImpact, is a privately-held pharmacy benefit manager (PBM) headquartered in San Diego,
California. Our solutions and services positively influence healthcare outcomes and expenditures, improving the position of our clients in the market. MedImpact offers high-value solutions to payers, providers and consumers of healthcare in the U.S. and foreign markets.

Equal Opportunity Employer, Male/Female/Disabilities/VeteransOSHA/ADA:

To perform this job successfully, the successful candidate must be able to perform each essential duty satisfactorily. The requirements listed are representative of the knowledge, skill, and/or ability required.
Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.

Disclaimer:

The above
statements are intended to describe the general nature and level of work being performed by people assigned to this classification. They are not intended to be construed as an exhaustive list of all responsibilities, duties, and skills required of personnel so classified.