Health Care that Starts with You!
Join a truly mission-driven organization! Independent, nonprofit UCare is recognized as one of the Minnesota's leading health plans. We provide more than 600,000 members across Minnesota and western Wisconsin with the health coverage plans and services they need to maintain and improve their health. The innovative coverage we create makes a difference for Medicare-eligible individuals, individuals and families enrolled in Minnesota Health Care Programs, such as MinnesotaCare and Medical Assistance, and disabled adults with special health care needs.
UCare is growing in size, membership, products, geographic coverage, and employees. We're an organization that's going places. Be part of a team that cares about you, be part of UCare.
Enter a highly collaborative environment where people are truly engaged, and feedback is valued. You'll enjoy a competitive salary and benefits, as well as a host of other perks, including a nationally recognized wellness program, and a bright, open, award-winning office space in Northeast Minneapolis just minutes from major freeways and retail centers.
At UCare, we welcome and employ a diverse employee group committed to meeting the needs of UCare, our members, and the communities we serve.
UCare offers Medicare, Medicaid, Individual and Family health plans - powered by the hardest working people in the industry. Our people powered teams de-complicate, advocate and always go the extra mile to help our members. We serve with integrity, compassion and commitment to do right by members, providers and government partners. Above all, we come to work excited to provide members a path for the best health of their lives.
WORKING AT UCARE
Working at UCare is more than a career; it's a mission. A mission that defines us as professionals, unites us as an organization and shapes how we interact with our members and each other. Employees join UCare and stay because of the opportunity to have a purpose-driven job.
Our strong culture has established UCare as a Star Tribune Top 200 Workplace for 14 consecutive years since the awards program began. It's a culture that embraces innovative ideas, strategic partnerships, and exemplary customer and provider experiences. Working at UCare is being a part of a people powered team dedicated to making a real difference in the lives of our members and communities.
PHARMACY CLINICAL OPERATIONS COORDINATOR
Work Location: Work from Home
As the Pharmacy Clinical Operations Coordinator, you will be responsible for member and provider communications related to formulary and other pharmacy benefit changes. Collaborate with Pharmacy Benefit Manager (PBM) and internal departments to develop formulary documents and tools, as well as maintenance and oversight activities. Day-to-day clinical operations tasks pertaining to medical drug authorization intake, maintaining associated criteria documents and authorizations lists. This role requires strong problem-solving, organization and communication skills as well as the ability to assimilate information and data from multiple sources.
• Develop and maintain an understanding of UCare products, benefits, pharmacy operations and clinical programs; including formulary knowledge, benefit management, materials, regulatory guidance and oversight; and appropriate drug claims processing.
• Apply knowledge and skills to a range of assignments requiring collaboration within the pharmacy team and across UCare including claims, IT, enrollment, finance, customer service, marketing, and quality improvement.
• Support projects as assigned within UCare, and represent pharmacy on cross-functional team projects.
• Create and maintain member and provider letters and website documents related to the pharmacy benefit. Facilitate regulatory review/ensure regulatory compliance and coordinate mailings with print vendors.
• Complete daily tasks, assist in the development of 1/1 readiness project plan and carry out responsibilities related to formularies, material updates and benefit testing, including the identification of key deadlines and milestones.
• Perform day to day formulary management duties including: prepare, analyze and update formulary documents for website posting and distribution, collaborate with vendors, PBM and internal departments to support formulary requirements, review findings and suggestions with Pharmacy Management team, understand and implement regulatory aspects (both CMS guidance and DHS regulations) of formulary maintenance.
• Assist with preparation of Pharmacy and Therapeutics Committee meetings as needed. Duties include: packet preparation, attending P&T meetings, prepare P&T minutes, posting P&T decisions to provider website and implementation of changes.
• Provide support for daily tasks related to medical drug authorization intake to ensure accurate entry and timely completion of authorization requests.
• Other projects and duties as assigned.
BA/BS preferred; demonstrated experience may be considered in lieu of degree. Pharmacy Tech CPhT preferred.
Three years of pharmacy operations experience in a PBM or health insurance setting. One year of project coordination experience in a health care environment.
Medicare Part D, State Public Programs and Healthcare Reform knowledge. Experience in gathering, translating and communicating technical business requirements. Proficiency with data analysis and validation. Strong knowledge of MS office products including Word, PowerPoint, and Excel. Process improvement experience. Background in policy and procedure development.
THE UCARE DIFFERENCE
The UCare difference is our people power - employees actively working on the behalf of our members to get them access to the health care they need. We value and respect each individual's ideas and contributions, and provide the freedom to grow both personally and professionally. We are centrally located, and offer onsite education, equipment and wellness resources, and a myriad of volunteer activities. If you're looking for an inclusive environment that celebrates your people power, helps you build on your strengths and gives you the opportunity to truly make a difference, we invite you to apply.
As an Equal Opportunity/Affirmative Action Employer, we welcome and employ a diverse employee group committed to meeting the needs of UCare, our members, and the communities we serve.
JOB POST DATE: 9/20/2023