Pharmacy Technician Consultant (Part-D)

The hiring range for this role is:  

78,638.00 - 110,285.00

This is the lowest to highest salary we, in good faith, believe we would pay for this role at the time of this posting.  We may ultimately pay more or less than the hiring range andthis hiringrange may also be modified in the future. A candidate’s position within the hiring range may be based on several factors including, but not limited to, specific competencies, relevant education, qualifications, certifications, relevant experience, skills, seniority, performance, shift, travel requirements, and business or organizational needs. This job is also eligible for annual bonusincentivepay.

We offer a comprehensive package of benefits including paid time off, 11 holidays, medical/dental/vision insurance, generous 401(k) matching, lifestyle spending account and many other benefits to eligible employees.

Note: No amount of pay is considered to be wages or compensation until such amount is earned, vested, and determinable. The amount and availability of any bonus, commission, or any other form of compensation that are allocable to a particular employee remains in the Company's sole discretion unless and until paid and may be modified at the Company’s sole discretion, consistent with the law.

The "Consultant Employer Group Waiver Plan (EGWP) Operations position supports the vendor relationship, daily operations, and delivery of member benefits for Medicare Part D Employer Group Waiver Plan (EGWP). This position collects, maintains, and resolves issues, shares program operational and performance data, supports timely resolution of inquiries, communication development, process documentation, reporting, implementation, compliance, and audit activities in support of and in compliance with the Federal Employee Program (FEP) Program, CS 1039, Office of Personnel Management (OPM), and Centers for Medicaid Services (CMS) EGWP Part D policies and regulations.

Primary Job Functions

• Oversees accurate and timely resolution of member inquiries including but not limited to CMS, OPM, internal and external sources.
• Identifies performance and compliance risks and communicate to leadership timely to minimize non-compliance. Reviews and tracks weekly, monthly, and quarterly reporting to identify any issues and implement corrective action strategies as needed.
• Assists with managing, tracking and approvals for communication requests, system updates, benefit changes in compliance with CMS and FEP requirements/standards.
• Support and interact with internal and external stakeholders to provide timely resolution to inquiries and issues.
• Fosters collaborative relationships with internal and external stakeholders and vendor account teams.

Increase Program value:

• Implements new programs to increase the value of our services. This includes planning, implementation, data analysis, communications, and outcome management.
• Review trends and industry information to determine best practices, operational efficiencies, or process improvements to enhance program performance and the member experience.

Compliance:

• Support development of operational standard operating procedures (SOP), policy, brochures, training materials and curriculum.
• Assist and support contract proposals, negotiations, counter proposals, SLA development, contract modifications and amendments.
• Coordinates the development and maintenance of program reporting and continuous review for outcomes in alignment with FEP goals.
• Support audit and compliance activities.

Education

Required: Bachelor’s degree in Pharmacy, Business, Accounting, Management, Health Services, Information Systems or equivalent work experience.

Experience

Required: Minimum of three years of experience within a business environment services delivery setting, with experience in project management, and/or healthcare informatics
Preferred:
• Experience in project management and/or account management

• Experience setting priorities and meeting objectives for projects with multiple stakeholders

• Technical proficiency with Microsoft Office, Teams and SharePoint


Knowledge, Skills, and Abilities

• Project management skills for reporting multiple projects, involving multiple stakeholders, under tight deadlines
• Advanced organizational skills with the ability to develop approaches that meet required objectives
• Excellent communication (written and oral) and interpersonal skills with an ability to communicate to small and/or large audiences (both internal and external to BCBSA)
• Technical proficiency with information technologies (e.g. Microsoft software applications)
• Interpersonal skills with the ability to work with all levels of the Association, Plans, government and vendors
• Ability to manage stakeholders and reconcile and integrate competing interests

Revenue/Budget Responsibility: No
People Management: No

Travel Requirements: 11-25%

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