About the Job
At PreferredOne, our name says it all! Everything we do is for one purpose – to make our valued members’ experience the best it can be. For 30 years, we have been loyal to serving Minnesota and the upper Midwest. We are known for our outstanding customer service and prompt claims processing. We offer the health insurance services members need and expect when looking for employer plans or individual coverage. We are committed to providing quality services that make a positive difference in administering health care benefits and helping our valued members reach their health related goals. Conveniently located in Golden Valley, MN.
Why consider PreferredOne for employment? We provide a welcoming, casual, and team-oriented culture. We also offer an array of wellness amenities to promote a healthy environment. Our employees can take advantage of our onsite fitness facility, massage therapist and personal trainer. No time to eat breakfast or make a lunch? No problem! We also offer an onsite cafeteria where our chef prepares fresh meals daily. In a recent survey, 97% of employees believe that PreferredOne cares about their wellbeing. Why? Our most valuable assets are our employees; our employees are what makes us unique. Coupled with our high retention rates, our employees receive impeccable benefits at affordable premiums. PreferredOne – a preferred employer.
To apply, submit your cover letter and resume along with salary requirement to firstname.lastname@example.org or via fax (763)-847- 4010.
Maintain current pharmacy programs. Assist in future development of the pharmacy program.
Duties and Responsibilities
- Manages clinical programs within PreferredOne.
- Performs research and analyses related to prescription drugs utilization.
- Perform medical overrides on medications in conjunction with medical management staff and medical director.
- Develop policies and procedures regarding the medical management and pharmacy related issues.
- Work with Business Systems in the plan set-up of benefits.
- Consult and report to employers regarding pharmacy benefits and potential quality cost programs that may be implemented.
- Performs analyses of claims data for fraud, waste, and abuse.
Required Education, Experience and Skills
- PharmD or Registered Pharmacist with several years direct pharmacy experience.
- 5 years minimum experience with a Pharmacy Benefits Manager (PBM) or health plan, including development of policies and procedures, managing relationships, ensuring compliance.
- Thorough knowledge of regulatory requirements, accreditation and experience applying requirements to internal processes and procedures.
- Excellent judgment.
- Excellent problem solving and decision-making.
- Excellent attention to detail.
- Excellent team player.
- Excellent oral and written communication.
- Excellent customer service.
- Ability to work in a Microsoft Office suite of products.
- Ability to work independently with minimal direction.
- Ability to work effectively in an environment characterized by high level of activities.
- Masters (e.g., MBA or MHA) or additional postgraduate training.
- Must be able to work on a computer for extended period of time.
- Must be able to operate all office equipment including: computer, copier, printers, fax machine and phone.
- Valid driver’s license is required.
- Occasional local travel will be required.