City/State

Work Shift

Overview:

Sentara Healthcare is currently hiring a Pharmacy Benefit & Compliance Specialist- Remote in Virginia!

Status: Full-time, permanent position (40 hours)

Work hours: 8am to 5pm EST, M-F

Location: This is a remote position in Virginia.

Job responsibilities:

• This position is responsible for supporting the Pharmacy Department's day-to-day operations for the benefits and compliance of all products and lines of business.

• Provides subject matter expertise related to analysis, implementation, and process improvement activities in support of the Pharmacy Department.

• The Pharmacy Benefit & Compliance Specialist creates and maintains reports for business operations and special projects as it pertains to operational processes.

• Utilizes knowledge of numerous applications, databases, information systems, statistical tools and analytical principles to monitor and analyze information in support of the business.

• Assists in the implementation, maintenance and improvement of information systems.

• The person should listen carefully to others in order to respond appropriately and professionally, answer questions, or obtain needed information with respect to pharmacy issues.

• This position will strongly collaborate with teams within Pharmacy Department, Senior Pharmacy Benefit & Compliance Specialists and internal Pharmacy teams to ensure compliance and benefit configuration needs.

Education

• HS - High School Grad or Equivalent REQUIRED

Certification/Licensure

• None required

Experience

• Managed Care- 1 year REQUIRED

• Compliance - 1 year highly preferred

• Pharmacy or Pharmacy Benefit Management (PBM) system experience preferred

• Strong proficiency in Microsoft Office Suite especially Excel preferred

• Experience in SQL a plus

Sentara Health Plans provides health plan coverage to close to one million members in Virginia. We offer a full suite of commercial products including employee-owned and employer-sponsored plans, as well as Individual & Family Health Plans, Employee Assistance Programs and plans serving Medicare and Medicaid enrollees.

Our quality provider network features a robust provider network, including specialists, primary care physicians and hospitals.

We offer programs to support members with chronic illnesses, customized wellness programs, and integrated clinical and behavioral health services—all to help our members improve their health.

Our success is supported by a family-friendly culture that encourages community involvement and creates unlimited opportunities for development and growth. 

Be a part of an excellent healthcare organization that cares about our People, Quality, Patient Safety, Service, and Integrity. Join a team that has a mission to improve health every day and a vision to be the healthcare choice of the communities that we serve!

To apply, please go to www.sentaracareers.com and use the following as your Keyword Search:  JR-100237

Talroo-Health Plan

Keywords: Managed Care, MCO, Healthcare, Health Plan, Health Insurance, Remote, Virginia, VA, Pharmacy Benefit, Compliance, Specialist, PBM, Express Scripts

Sentara Health is an equal opportunity employer and prides itself on the diversity and inclusiveness of its close to an almost 30,000-member workforce. Diversity, inclusion, and belonging is a guiding principle of the organization to ensure its workforce reflects the communities it serves.

In support of our mission “to improve health every day,” this is a tobacco-free environment.

For positions that are available as remote work, Sentara Health employs associates in the following states:

Alabama, Delaware, Florida, Georgia, Idaho, Indiana, Kansas, Louisiana, Maine, Maryland, Minnesota, Nebraska, Nevada, New Hampshire, North Carolina, North Dakota, Ohio, Oklahoma, Pennsylvania, South Carolina, South Dakota, Tennessee, Texas, Utah, Virginia, Washington, West Virginia, Wisconsin, and Wyoming.