Remote Associate Formulary Analyst

Summary

Join Abarca as an Associate Formulary Analyst and contribute to revolutionizing healthcare by configuring and implementing formularies across Medicare, Commercial, and Employer clients. As a key member of the team, you will execute standard formulary setups, perform unit testing, conduct design reviews, and support research and resolution of adjudication and processing issues.

Requirements

• Associate or Bachelor’s degree in a related field (In lieu of a degree, equivalent, relevant work experience may be considered.)
• 1 + years of experience in a healthcare non-retail pharmacy setting within a similar or related role
• Pharmacy Technician accreditation as well as a current and active license
• Experience with areas of clinical expertise
• Experience applying customer service and presentation skills within clinical operations
• Excellent oral and written communication skills. Bilingual fluency in Spanish and English is required

Responsibilities

• Execute standard formulary setups for new Medicare, Commercial and Employer client implementations, and process changes for existing clients
• Perform unit testing to confirm configuration set-up or changes are processing as expected as defined in the client documentation
• Conduct design review of peers on the proposed build design and configuration peer review
• Perform Quality Control and Quality Assurance functions to assess information accuracy in all Formulary Management processes
• Support the research and resolution of adjudication and processing issues including, identification of root cause, impact analysis determination and corrective action
• Apply appropriate sense of urgency support to other areas to verify and analyze claims processing cases, eligibility, and other operational situations and issues referred for validation within SLAs/SLOs
• Collaborate and coordinate with other business units to execute configuration as required
• Responsible for daily tracking and monitoring of assigned requests to ensure due dates are met

Benefits

Flexible hybrid work model which will require certain on-site work days (Puerto Rico Location Only)