[Hiring] Pharmacy Benefit & Compliance Specialist @Sentara Health

Role Description

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.
• 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.
• Listens carefully to others in order to respond appropriately and professionally, answer questions, or obtain needed information with respect to pharmacy issues.
• Collaborates with teams within the Pharmacy Department, Senior Pharmacy Benefit & Compliance Specialists, and internal Pharmacy teams to ensure compliance and benefit configuration needs.

Qualifications

• HS - High School Grad or Equivalent (REQUIRED)
• 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)

Benefits

• Medical, Dental, Vision plans
• Adoption, Fertility, and Surrogacy Reimbursement up to $10,000
• Paid Time Off and Sick Leave
• Paid Parental & Family Caregiver Leave
• Emergency Backup Care
• Long-Term, Short-Term Disability, and Critical Illness plans
• Life Insurance
• 401k/403B with Employer Match
• Tuition Assistance – $5,250/year and discounted educational opportunities through Guild Education
• Student Debt Pay Down – $10,000
• Reimbursement for certifications and free access to complete CEUs and professional development
• Pet Insurance
• Legal Resources Plan
• Colleagues have the opportunity to earn an annual discretionary bonus if established system and employee eligibility criteria are met.

Company Description

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!