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Posted: Thursday, February 8, 2018 12:07 AM

Job Description
Job description
Pricing Assurance Analyst
The Pricing Assurance Analyst is responsible for creating, analyzing and making suggestions for various pricing schedules, Maximum Allowable Cost (MAC) lists, and executive level reporting by coordinating with pharmacy benefit management (PBM) and mail order operations. This position has no direct reports.
ESSENTIAL DUTIES AND RESPONSIBILITIES:
:Execute the MAC appeal process by consolidating data, researching industry pricing, and evaluating research and pricing proposals for appropriateness, accuracy, and impact
:Respond to pricing inquiries from business partners in a timely manner
:Update MAC lists in adjudication system and provide quality assurance of other system changes as necessary
:Verify that claims performance adheres to the effective rate strategy and examine deviations from the target rate
:Perform effective rate reporting for executive management to ensure that both corporate goals and contractual obligations are met
:Assess and validate claim adjudication setups by pharmacy and by client and investigate sources of discrepancies
:Complete mail order pricing reports to determine the usefulness of rates and margins
:Report on discount card performance such as changes in product utilization, volume, discount rates, usual and customary rates and market share
:Review and prepare claims data uploads for external auditors
:Monitor new generic drug entrance and expansion in the market and coordinate with pharmacy services on pricing
:Assist with preparation and maintenance of generic pricing throughout the MAC list across all lines of business
:Estimate the impact of weekly price changes as well as periodic changes to manufacturer contracts
:Provide support as needed on relevant MAC processes and projects
:Conduct special studies and investigations and report findings to department leaders
:Other duties as assigned
REQUIREMENTS:
:Bachelors degree in business, mathematical, statistical, financial, or applied science discipline strongly preferred; proven industry experience will be acceptable in lieu of degree
:Minimum 1 to 2 years relevant pricing or finance experience, preferably with a PBM
:Ability to work extended hours, weekends and holidays pursuant with industry demands
:Proficient in Microsoft Office and industry related software programs
PREFERRED QUALIFICATIONS:
:Financial and statistical reporting knowledge and experience
:Effective verbal and written communication skills
:A decisive individual who possesses a detail oriented perspective
:A strategic planner with sound technical skills, analytical ability, good judgment and strong operational focus
:Ability to work with peers in a team effort
:Demonstrated ability to manage multiple priorities and deadlines
:Capability to efficiently complete tasks in a fast paced environment
:Crystal reporting, MS Access, and SQL programming knowledge and experience strongly preferred
WORK ENVIRONMENT:
Includes a typical office environment, with minimal exposure to excessive noise or adverse environmental issues.
PHYSICAL REQUIREMENTS:
Ability to sit for prolonged periods of time.
Pre:employment drug screening and background checks are required. The company offers a competitive salary and benefits package. EOE. All qualified applicants receive consideration for employment without regard to race, color, religion, sex, national origin, disability or veteran status.
EnvisionRxOptions is committed to maintaining a productive, drug:free workplace that keeps employees and customers safe from harm.
Company Description
EnvisionRx, with a commitment to providing transparency and disclosure to the Pharmacy Benefit Management (PBM) marketplace, provides full service, integrated PBM services, including network:pharmacy claims processing, mail order, benefit design consultation, drug utilization review, formulary management, and other related services. If you are interested i

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• Location: Cleveland

• Post ID: 58461742 cleveland
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