Reimbursement Analyst

Principle Responsibilities

• Analyze pharmacy claims data utilization to identify financial trends, opportunities, and potential risks, including changes to profit margins.
• Work with Pharmacy Network to identify new contract requirements and methods to validate set up in the system.
• Schedule review and quality assurance of reimbursement in the system.
• Aid the legal team by monitoring, understanding, and acting on state MAC laws.
• Maintain contractual Generic Effective Rate agreements.
• Aid with the implementation of new MAC tables for new clients.
• Aid with MAC review appeals from pharmacies & clients.
• Communicate MAC prices of new drugs with other team members.

Requirements

• Bachelor’s degree in Finance, Economics or other business-related field, or 4+ years of financial or pricing analysis experience in PBM or Healthcare related field preferred.
• Demonstrate expanded understanding of advanced Excel functionality preferred.
• Aptitude to learn or demonstrated understanding of databases and query languages (e.g., SQL, DBF, Access, SAS, etc.) preferred.
• Able to effectively communicate, verbally and in writing, potentially technical information to a non-technical audience preferred.
• Able to work independently and in a fast-paced environment preferred.
• Strong analytical and problem-solving skills preferred.

Physical Demands

Requires sitting, standing, and occasional light lifting.

The Perks Of Joining Our Team

• Comprehensive Health Benefits: Medical, Dental, Vision, Short-Term/Long-Term Disability Insurance, Life insurance.
• Time to Recharge: Paid vacation and holiday pay.
• Focus on Your Wellness: We offer a robust Employee Wellness Program.
• Invest in Your Future: 401 k with a company match.
• Support System: Employee Assistance Program provides confidential support and counseling.
• Employee referral program.

Company Information

We believe in taking care of our team. You'll enjoy a comprehensive benefits package designed to support your well-being and financial future.

All interviews are conducted in-person OR through video conference invitations from official company emails.

For inquiries, please contact our official recruitment team at HumanResources@procarerx.com.

ProCare Rx is an Equal Opportunity Employer.