MVP Health Care Hiring for Professional, Pharmacy Coordinator at Rochester, NY  Full Time

Tuesday, August 22, 2023

Over 35 years strong and fueled by 1,700 smart, passionate employees across New York state and Vermont, MVP is full of opportunities to grow. We are a nationally recognized, award-winning leader for a reason. The beating heart of our company is a wide range of employees from a diverse set of backgrounds-tech people, numbers people, even people people-working together to make health insurance better. If you are ready to join a thriving, mission-driven company where you can create your own opportunities and make a positive difference-it’s time to make a healthy career move to MVP!

Status: Full Time, Exempt

The individual will work with MVP contracted pharmacy benefits manager, ePA system, and internal departments to ensure a positive member experience. Responsible for reviewing and monitoring weekly/monthly Medicare cases (universes); ensuring universes and reporting are correct and working within ePA system. Responsible for yearly Medicare monitoring and reporting. Acts as a departmental resource with regards to pharmacy operations. Responsible for monitoring, running and submitting reports in conjunction with other pharmacy team members and other departments using multiple analytic software/programs. Participates in audit preparation and audit presentations. Performs other related duties as assigned. Policy and procedure creation, updates, and monitoring. Coordinate, validate and submit CMS reporting. Coordinate product benefit development, pre-production testing and monitoring with Pharmacy Operations Coordinator to ensure all regulatory requirements are addressed, monitored, and documented.

POSITION QUALIFICATIONS:

Minimum Education:

• BA/BS degree strongly preferred. Equivalent, relevant managed care experience may be considered in lieu of a college degree.

Minimum Experience:

• Minimum of 2 years’ work experience in healthcare/health insurance required.
• Two years in a pharmacy related role within healthcare preferred.

Required Skills:

• Microsoft Word, Access, PowerPoint, and Excel (intermediate skill level)
• Exceptional organizational, presentation, written, and verbal communication skills.
• Knowledge of pharmacy claims processing and pharmacy benefit designs
• Knowledge of medical claims processing and medical benefit designs
• Excellent analytical skills required.
• Superior attention to detail and strong project management skills
• Ability to lead and contribute in meetings to gather requirements and communicate status.
• Ability to sit at a workstation for extended periods.

Preferred Skills:

• Some statistical background or experience a plus

About MVP
MVP Health Care is a nationally recognized, not-for-profit health insurer caring for more than 700,000 members in New York and Vermont. Committed to the complete well-being of our members and the communities we serve, MVP makes health insurance more convenient, more supportive, and more personal. We are powered by the ideas and energy of more than 1,700 diverse, employees from all backgrounds, committed to having a positive impact on the health and wellness of everyone we serve. MVP Health Care is an Affirmative Action/ Equal Employment Opportunity (PDF). We recruit, employ, train, compensate, and promote without regard to race, religion, creed, color, national origin, age, gender, sexual orientation, marital status, disability, genetic information, veteran status, or any other basis, e.g., Pay Transparency (PDF), and the Know your Rights protected by applicable federal, state or local law. Any person with a disability needing special accommodations to the application process, please contact Human Resources at [email protected]

Please apply and learn more – including how you may become a proud member of our team.

Other details

• Job Family Pharmacy
• Pay Type Salary