Description

The Pharmacy Network Business Systems Analyst – Pharmacy Networks, supports the design, maintenance, and expansion of the PHP pharmacy network, inclusive of establishing and maintaining collaborative relationships with our network partners as well as contract maintenance and negotiation. The successful candidate for this role will have experience in claims processing and payment, contracting, policy development, and supporting the development and implementation of network strategy. This role designs, develops, and executes the business requirements necessary to assure the accurate processing of prescription claims at participating pharmacies utilizing eligibility, benefits, formularies and drug utilization management edits in a point-of service environment. This role requires coordination and collaboration with internal and external parties and business partners, and experience in managing projects, working with pharmacy claims data, interpretation of regulatory requirements, and executing on deliverables is desired.

Providence caregivers are not simply valued – they’re invaluable. Join our team at Providence Health Plan Partners and thrive in our culture of patient-focused, whole-person care built on understanding, commitment, and mutual respect. Your voice matters here, because we know that to inspire and retain the best people, we must empower them.

Required qualifications:

• Bachelor's Degree in Business Administration, Healthcare Administration or Healthcare related field. Or 4 years additional experience as a Pharmacy Technician or a related healthcare field.

• Coursework/Training: Medication and drug product category training and medical terminology.

• 5 years Experience as a Pharmacy Technician or directly related field.

• 1 year Managed care pharmacy experience.

Required Licenses and Certification:

• Required upon hire: Oregon Pharmacy Technician License

• Required within 1 year of hire: Oregon Certified Oregon Pharmacy Technician

Preferred qualifications:

• Coursework/Training: Project management, Six Sigma Change Acceleration Process (CAP), LEAN, and Work Out training.

• Project management, Six Sigma Change Acceleration Process (CAP), LEAN, and Work Out experience.

• Sharepoint experience.

• Office 365

• 2 years of experience in contract negotiation, maintenance, pharmacy reimbursement, and contracting software

• 2 years of experience in analyzing and interpreting contractual, legal, regulatory, and legislative provisions to ensure contracts meet business and regulatory compliance.

Why Join Providence?

Our best-in-class benefits are uniquely designed to support you and your family in staying well, growing professionally, and achieving financial security. We take care of you, so you can focus on delivering our Mission of caring for everyone, especially the most vulnerable in our communities.

Accepting a new position at another facility that is part of the Providence family of organizations may change your current benefits. Changes in benefits, including paid time-off, happen for various reasons. These reasons can include changes of Legal Employer, FTE, Union, location, time-off plan policies, availability of health and welfare benefit plan offerings, and other various reasons.

About Providence

At Providence, our strength lies in Our Promise of “Know me, care for me, ease my way.” Working at our family of organizations means that regardless of your role, we’ll walk alongside you in your career, supporting you so you can support others. We provide best-in-class benefits and we foster an inclusive workplace where diversity is valued, and everyone is essential, heard and respected. Together, our 120,000 caregivers (all employees) serve in over 50 hospitals, over 1,000 clinics and a full range of health and social services across Alaska, California, Montana, New Mexico, Oregon, Texas and Washington. As a comprehensive health care organization, we are serving more people, advancing best practices and continuing our more than 100-year tradition of serving the poor and vulnerable.

The amounts listed are the base pay range; additional compensation may be available for this role, such as shift differentials, standby/on-call, overtime, premiums, extra shift incentives, or bonus opportunities.

Check out our benefits page for more information about our Benefits and Rewards.

About the Team

Providence Shared Services is a service line within Providence that provides a variety of functional and system support services for our family of organizations across Alaska, California, Montana, New Mexico, Oregon, Texas and Washington. We are focused on supporting our Mission by delivering a robust foundation of services and sharing of specialized expertise.

Providence is proud to be an Equal Opportunity Employer. We are committed to the principle that every workforce member has the right to work in surroundings that are free from all forms of unlawful discrimination and harassment on the basis of race, color, gender, disability, veteran, military status, religion, age, creed, national origin, sexual identity or expression, sexual orientation, marital status, genetic information, or any other basis prohibited by local, state, or federal law. We believe diversity makes us stronger, so we are dedicated to shaping an inclusive workforce, learning from each other, and creating equal opportunities for advancement.

Requsition ID: 283609
Company: Providence Jobs
Job Category: Analytics/Business Intelligence
Job Function: Information Technology
Job Schedule: Part time
Job Shift: Day
Career Track: Business Professional
Department: 5018 PHARMACY OR REGION
Address: OR Beaverton 3601 SW Murray Blvd
Work Location: Murray Business Ctr Beaverton-Beaverton
Pay Range: $37.10 - $58.73
The amounts listed are the base pay range; additional compensation may be available for this role, such as shift differentials, standby/on-call, overtime, premiums, extra shift incentives, or bonus opportunities.
Check out our benefits page for more information about our Benefits and Rewards.