Education/Training:Certified Pharmacy Technician is required. BS / BA PREFERRED
- Must have education and background in medical terminology / medical coding / medical claims processing
- Knowledge of Pharmaceutical products, their use and related therapeutic categories
- Knowledge with reimbursement channels for pharmaceutical products and or pharmaceutical insurance benefits
- Strong computer skills –including a demonstrated proficiency in Microsoft Office with a focus on MS Excel and MS PowerPoint
- Strong communication, follow-up, organizational skills, and extremely high attention to detail
- Must have the ability to work under deadline pressure, follow specific direction and guidelines and operate with minimal daily supervision while focusing on individual and team measurements and goals
The Coverage Policy Analyst is responsible for researching and collecting source material for pharmacy and medical coverage. Once collected the Analyst is responsible for the processing of these source materials into database inputs. The Analyst is required to apply company specific QC measures as these source materials are normalized. Any anomalies or errors must be identified and reported to the appropriate supervisor.
Some source material will require an on-going conversation with a contact at a healthcare plan (a monthly or quarterly discussion). The Analyst will establish the relationship with the contact and conduct the monthly / quarterly calls as appropriate.
- Research and gather all pertinent coverage policy information via the Managed Care Organization website.
- Evaluate and standardize coverage policy information for entry into database.
- Perform data entry and verification of data files.
- Retrieve data and/or produce various reports.
- Distribution of reports, forms, etc.
- Ability to track changes and maintain historical trends.
- Develop, maintain, update, delete various files, reports, surveys, etc.
- Interface on concert with other co-workers and departments to share ideas, information, expertise and analysis.
- Provide administrative support to the Operations Department.
- Performs other duties as assigned.
- Supports the Mission, Values and Vision of BusinessOne Technologies, Inc.
- Supports, cooperates with, and implements specific procedures and programs for:
- Safety, including universal precautions and safe work practices, established fire/safety/disaster plans, risk management, and security, report and/or correct unsafe working conditions, equipment repair and maintenance needs.
- Confidentiality of all data, including employee and operations data;
- Quality Assurance and compliance with all regulatory requirements.
- Compliance with current law and policy to provide a work environment free from sexual harassment and all illegal and discriminatory behavior.
- Supports and participates in common teamwork:
- Cooperates and works together with all co-workers; plan and complete job duties with minimal supervisory direction, including appropriate judgment.
- Uses tactful, appropriate communications in sensitive and emotional situations.
- Follows up as appropriate with supervisor or co-workers regarding reported complaints, problems and concerns.
- Promotes positive public relations with clients and guests.
- Completes requirements for training, acceptable attendance, uniform and dress codes including personal hygiene, and other work duties as assigned.
Location:Bernardsville, NJ or Bensalem, PA
About BusinessOne Technologies, Inc.
BusinessOne Technologies collects, integrates and analyzes data to provide creative solutions, competitive insights and strategic direction to life sciences companies that need current market intelligence to optimize product access. From pre-launch to post-marketing, BusinessOne delivers unique market perspectives through custom research, analytics and direct on-line access to integrated managed markets data, including formulary, drug coverage policy detail, benefit design, reimbursement, demographics and utilization at the plan and physician level.