Specialty Drug Administrator I - Bilingual

Exemption Status:

United States of America (Non-Exempt)

Exemption Status:

$16.47 - $20.80 - $25.13

“Pay scale information is not necessarily reflective of actual compensation that may be earned, nor a promise of any specific pay for any selected candidate or employee, which is always dependent on actual experience, education, qualifications, and other factors.  A full review of our comprehensive pay and benefits will be discussed at the offer stage with the selected candidate.”

Ray Savings Solutions, LLC. is looking for extraordinary people to join our team!

Why join Ray Savings Solutions, LLC? Because our success is dependent on you; innovative professionals with top notch skills who thrive on opportunity, high performance, and teamwork. We look for individuals who want to work on a team that cares about making a difference in the value of healthcare.

At Ray Savings Solutions, LLC., we deliver leading edge pharmaceutical and technology related solutions that dramatically improve the value of health care. We provide superior outcomes to those we serve through innovative products, systems, and services that provide transparency and promote choice in decision making. Our vision is to set the standard in providing solutions that optimize satisfaction, service, cost, and quality in the healthcare industry. We are the premier Pharmacy Benefits Management solution!

Job Description

Summary

Working as the liaison between the member, healthcare providers, and prescription drug assistance programs, the Specialty Drug Program Administrator helps to connect members to prescription drug assistance programs that will facilitate members to receive medications at no charge or at a discounted price.  The Specialty Drug Program Administrator will work directly with members and physicians to ensure all required paperwork for a MAP/PAP application is completed and submitted to the manufacturer. Once a coverage determination has been made by the manufacturer, the Specialty Drug Program Administrator will work directly with the PBM and dispensing pharmacy to ensure the claim approves appropriately and the member receives their medication.

Essential Duties and Responsibilities

• Perform patient & physician outreach; educating patient on potential Alternate Funding programs as they relate to their specific benefit.
• Provide all necessary paperwork and documentation to the patient and physician and follow-up on appropriate manufacturer program to determine patient eligibility.
• Enter benefit overrides as applicable to ensure pharmacy receives a paid claim once funding has been secured.
• Provide all necessary billing information to the dispensing pharmacy once funding has been approved.
• Ensure patients are aware of documentation requirements for the program to ensure application for refills or new application process can proceed.
• Thoroughly document patient contacts, patient information, and other related agency activities in the case file.
• Performs other duties as assigned by Principal Enterprise Drug Product Solutions.

Supervisory Responsibilities

No supervisory responsibilities

Client Responsibilities

This is an internal and external client facing position that requires excellent customer service skills and interpersonal communication skills (listening/verbal/written).  One must be able to; manage difficult or emotional client situations; Respond promptly to client needs; Solicit client feedback to improve service; Respond to requests for service and assistance from clients; Meet commitments to clients.

Qualifications

To perform this job successfully, an individual must be able to perform each essential duty satisfactorily. The requirements listed below are representative of the knowledge, skill, and/or ability required. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.

Education and/or Experience

GED/HS Diploma and 6+ months’ experience or equivalent combination of education and experience

Computer Skills

Strong proficiency with MS Office / Word, PowerPoint, Excel, Project, Visio, and Outlook to create complex documents, manage schedules, and analyze data.  Strong proficiency with MedImpact and/or MedImpact Direct systems including MedAccess, MedOptimize, and Salesforce. Skills that are desirable, but not required include SQL query development, Golden32 or other equivalent database browsing software, and Excel macro programming.

Certificates, Licenses, Registrations

None required

Other Skills and Abilities

• Demonstrates ability to appear for work on time, follow directions from a supervisor, interact well with co-workers, understand and follow work rules and procedures, comply with corporate policies, goals and objectives, accept constructive criticism, establish goals and objectives, and exhibit initiative and commitment. 

Reasoning Ability

•   Ability to define problems, collect data, establish facts, and draw valid conclusions.

• Ability to interpret an extensive variety of technical instructions in mathematical or diagram form and deal with several abstract and concrete variables.

Mathematical Skills

• Ability to calculate figures and amounts such as discounts, interest, commissions, proportions, percentages, area, circumference, and volume.  Ability to apply concepts of basic algebra and geometry.

• Ability to apply concepts such as fractions, percentages, ratios, and proportions to practical situations.

Language Skills

• Ability to read, analyze, and interpret general business periodicals, professional journals, technical procedures, or governmental regulations. 

• Ability to effectively present information and respond to questions from groups of managers, clients, customers, and the general public.

Competencies To perform the job successfully, an individual should demonstrate the following competencies:

• Composure
• Decision Quality
• Organizational Agility
• Problem Solving
• Customer Focus
• Drive for Results
• Peer Relations
• Time Management
• Dealing with Ambiguity
• Learning on the Fly
• Political Savvy

Physical Demands

The physical demands described here are representative of those that must be met by an employee to successfully perform the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.

While performing the duties of this Job, the employee is regularly required to sit and talk or hear. The employee is regularly required to stand; walk; use hands to finger, handle, or feel and reach with hands and arms. The employee must occasionally lift and/or move up to 25 pounds.

Work Environment

The work environment characteristics described here are representative of those an employee encounters while performing the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.

This position may regularly be exposed to or encounter moving mechanical parts, high, precarious places, fumes or airborne particles, toxic or caustic chemicals, outdoor weather conditions, risk of electrical shock or vibration. The noise level in the work environment is usually moderate (examples: business office with computers and printers, light traffic).

Work Location

This position must work on-site at the San Diego Headquarters or other company location for purposes of providing adequate support to internal clients; being available for face-to-face interactions and coordination of work with other employees, colleagues, clients, or vendors; as well as for facilitation of quick and effective decisions through collaboration with stakeholders.  Remote work is not an option for these purposes.

Working Hours

This is a full-time non-exempt position requiring one to be able to work overtime from time to time in order to get the job done.  Therefore, one must have the ability to work nights, weekends or on holidays as required.  This may be changed at any time to meet the needs of the business.  The typical working hours for this position are Monday through Friday from 8:00am to 5:00pm.

Travel

This position requires no travel however attendance maybe required at various local conferences and meetings.

The Perks:

• Medical / Dental / Vision / Wellness Programs

• Paid Time Off / Company Paid Holidays

• Incentive Compensation

• 401K with Company match

• Life and Disability Insurance

• Tuition Reimbursement

• Employee Referral Bonus

To explore all that MedImpact has to offer, and the greatness you can bring to our teams, please submit your resume to www.medimpact.com/careers

MedImpact, is a privately-held pharmacy benefit manager (PBM) headquartered in San Diego, California. Our solutions and services positively influence healthcare outcomes and expenditures, improving the position of our clients in the market. MedImpact offers high-value solutions to payers, providers and consumers of healthcare in the U.S. and foreign markets.

Equal Opportunity Employer, Male/Female/Disabilities/Veterans

OSHA/ADA:

To perform this job successfully, the successful candidate must be able to perform each essential duty satisfactorily. The requirements listed are representative of the knowledge, skill, and/or ability required. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.

Disclaimer:

The above statements are intended to describe the general nature and level of work being performed by people assigned to this classification. They are not intended to be construed as an exhaustive list of all responsibilities, duties, and skills required of personnel
so classified.