Molina Healthcare
Job Description
Responsible for ensuring Molina members have access to all medically necessary prescription drugs and that those drugs are used in a cost-effective, and safe manner. Responsible for creating, operating, and monitoring Molina Health Plan’s pharmacy services programs in accordance with all federal and state laws.
Job Summary Responsible for ensuring Molina members have access to all medically necessary prescription drugs and that those drugs are used in a cost-effective, and safe manner. Responsible for creating, operating, and monitoring Molina Health Plan’s pharmacy services programs in accordance with all federal and state laws.
Knowledge/Skills/Abilities
Monitor the operational aspects of the Pharmacy Benefits Manager and other delegates to assure compliance with contractual and regulatory requirements.
Collaborate with other departments to secure the data and analysis necessary to support state reporting and delegation oversight (both internal and external).
Support and complete all audits as required (SOX, CMS, internal, Network).
Assist management by preparing and analyzing compliance/audit reports.
Assist in the implementation and oversight of processes, policies and procedures.
Prepare, research, and validate information for both internal and external program audits.
Other duties as assigned
Job Qualifications Required Education Associate’s Degree or equivalent combination of education and experience
Required Experience 3+ years managed care pharmacy or PBM experience
Required Knowledge, Skills and Abilities Strong results-oriented, Strong written, verbal and interpersonal skills; Ability to multi-task, prioritize and manage time effectively; Strong Computer skills; advanced Microsoft Office proficiency; detailed oriented, experience with handling large amounts of data, strong analytic skills; able to collaborate cross-functionally; experience working within a team
Preferred Education
Bachelor of Science
Preferred Experience Prior operational experience executing PBM and Specialty Pharmacy contracts on behalf of large payer(s)
To all current Molina employees: If you are interested in applying for this position, please apply through the intranet job listing.
Molina Healthcare offers a competitive benefits and compensation package. Molina Healthcare is an Equal Opportunity Employer (EOE) M/F/D/V.
Pay Range: $21.16 - $42.2 / HOURLY
*Actual compensation may vary from posting based on geographic location, work experience, education and/or skill level.
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Job Summary Responsible for ensuring Molina members have access to all medically necessary prescription drugs and that those drugs are used in a cost-effective, and safe manner. Responsible for creating, operating, and monitoring Molina Health Plan’s pharmacy services programs in accordance with all federal and state laws.
Knowledge/Skills/Abilities
Monitor the operational aspects of the Pharmacy Benefits Manager and other delegates to assure compliance with contractual and regulatory requirements.
Collaborate with other departments to secure the data and analysis necessary to support state reporting and delegation oversight (both internal and external).
Support and complete all audits as required (SOX, CMS, internal, Network).
Assist management by preparing and analyzing compliance/audit reports.
Assist in the implementation and oversight of processes, policies and procedures.
Prepare, research, and validate information for both internal and external program audits.
Other duties as assigned
Job Qualifications Required Education Associate’s Degree or equivalent combination of education and experience
Required Experience 3+ years managed care pharmacy or PBM experience
Required Knowledge, Skills and Abilities Strong results-oriented, Strong written, verbal and interpersonal skills; Ability to multi-task, prioritize and manage time effectively; Strong Computer skills; advanced Microsoft Office proficiency; detailed oriented, experience with handling large amounts of data, strong analytic skills; able to collaborate cross-functionally; experience working within a team
Preferred Education
Bachelor of Science
Preferred Experience Prior operational experience executing PBM and Specialty Pharmacy contracts on behalf of large payer(s)
To all current Molina employees: If you are interested in applying for this position, please apply through the intranet job listing.
Molina Healthcare offers a competitive benefits and compensation package. Molina Healthcare is an Equal Opportunity Employer (EOE) M/F/D/V.
Pay Range: $21.16 - $42.2 / HOURLY
*Actual compensation may vary from posting based on geographic location, work experience, education and/or skill level.
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