The essential functions of Pharmacy Benefit Consultants include providing high-level pharmacy benefit and related systems expertise and guidance to customers and staff, mentoring and training less experienced analysts, leading and consulting on the most complex or high exposure projects, and consulting on product vision, planning, and forecasting.
In this role, the candidate will work with business owners and their leaders to help them contain costs, simplify administration, and minimize employer-related risk by moving to a consolidated HR model.
In this role, the selected candidate will coordinate and perform onsite medical record reviews at provider offices to determine appropriate coding and billing practices, compliance with quality metrics, compliance with service delivery and quality standards, and where assigned investigation of quality of care and member complaints relative to quality of care and service.
In this role, you will build, execute, and validate system statistical queries/reports to monitor system quality and stability. Identify and research statistical anomalies. Resolve or assign issues for resolution.
In this role, the selected candidate will find and develop prospects by heavy networking, referrals, cold calling, direct selling, business development through support organizations, and Centers of Influence.
In this role, the selected candidate will be responsible for conducting audit testing to determine compliance with policies and procedures and to assess suitability of internal control design/operating effectiveness.
In this position, the qualified individual will design new enclosure systems, and design repairs for existing enclosure systems. They will perform review of enclosure systems for new construction, renovation, and restoration projects.
In this position the qualified individual will investigate and determine the service life of building enclosure assemblies. The qualified individual will design new enclosure systems, and design repairs for existing enclosure systems.