This position represents Benefits Administration, participating in the full life cycle of formulary and clinical program development by providing the leadership and oversight of benefit related requirements, impact analysis, advising and helping formulate process developments, responsible for formulary implementation within the Benefits landscape as well as appropriate formulary maintenance and testing. Develops and fosters the relationship and interaction between the Benefit Configuration Formulary Team, Clinical, Account Services Benefit Configuration and IT Teams.
Serves as a SME interface between Benefits Configuration and the Clinical and Account Services Benefit Configuration teams in the development of clinical programs and formulary management changes.
Provides Benefit Configuration related build and maintenance support for assigned clinical programs.
Represents Benefit Configuration in working with the Clinical team on clinical requirements development and deployment.
Coordinates activities of the Formulary Benefit Configuration team; recommends measures to improve performance and efficiency.
Efficient and effective distribution of tasks, using clear and concise instructions and expectations.
Responsible for mentoring and training team members.
Serves as a skilled clinical resource in support of non-clinical team members.
Identifies the common causes of the defects, prioritizes them and systematically removes defects to avoid recurrences in further development work.
Works with Clinical team to understand the customer's product-specific requirements and configuration and translates them to benefit technical design specifications and data flow from which programs are developed and coded.
Interacts with Clinical and IT development teams during the software build or configuration and testing process.
Responsible for development and maintenance of Benefit Configuration Formulary intake Queue, workflow and reporting-Performs and oversees the technical application configuration
Oversees the design and execution of unit, system and integration test plans for new formulary based benefit related developments/releases/reports.
Maintains formulary related technical documentation based on standard operating procedures in support of the assigned clinical application.
Assumes complete ownership for Benefit Configuration related assigned tasks and communicates the progress of the project plan / task to all stakeholders regularly.
Works closely with end users to identify problems and provide solutions.
Demonstrates an understanding of end users business needs and works closely with end users to identify problems and provide solutions.
Performs other duties as assigned.
Other Job Requirements
Responsibilities
Minimum of 7 years of pharmacy and/or pharmacy information systems experience.Minimum of 4 years of experience within a technology environment, preferably within a healthcare setting. Experience with data analysis, programming frameworks or other end-user reporting programs and creating macros in spreadsheet environments. Ability to operationalize process improvements.Proven experience working with cross-functional teams driving alignment to common goals and positive outcomes.
General Job Information
Title
Lead Formulary Analyst
Grade
23
Work Experience - Required
PBM (Pharmacy Benefit Management), Pharmacy
Work Experience - Preferred
Education - Required
GED, High School
Education - Preferred
Bachelors
License and Certifications - Required
License and Certifications - Preferred
CPT/ExCPT/LPT/PTCB/RPT, Pharmacy Technician, State Requirements - Pharmacy
Magellan Health, Inc. is proud to be an Equal Opportunity Employer and a Tobacco-free workplace. EOE/M/F/Vet/Disabled.Every employee must understand, comply with and attest to the security responsibilities and security controls unique to their position; and comply with all applicable legal, regulatory, and contractual requirements and internal policies and procedures.
Magellan is the employer of choice for hard working people interested in making a difference in the health care industry and in the communities where we work and live. Our strong culture of caring is the common thread in both our business strategy and our work environment. We value professional growth and development, total health and wellness, rewards and recognition as well as employee unity. Magellan is a place where you can thrive.
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