The job below is no longer available.
You might also like
in Etters, PA
- $50
est. per hour - $27
est. per hour Ryder System • 9h agoUrgently hiring 9.9 mi Use left and right arrow keys to navigate 
Sinclair Broadcast Group • 5h agoUrgently hiring 9.5 mi Use left and right arrow keys to navigate- $32
est. per hour System One • 13h agoJust posted Urgently hiring 12 mi Use left and right arrow keys to navigate - $17
est. per hour
Director - Pharmacy Systems (Licensed Pharmacist)
•30 days ago
| Hours | Full-time, Part-time |
|---|---|
| Location | Etters, Pennsylvania |
About this job
Job Description:
SUMMARY The primary purpose of this position is to oversee the company’s prescriber file, monitor and develop pharmacy claim edits, instruct pharmacies on the processing of third party claims, and reduce the number of audit chargebacks. Frequent independent judgments are essential. The incumbent is also required to perform all tasks in a safe manner consistent with corporate policies and state and federal laws.
ESSENTIAL DUTIES AND RESPONSIBILITIES The associate is responsible for the functions below, in addition to other duties as assigned:
Monitor the integrity of the company’s prescriber file through monitoring of the weekly prescriber validation system, Real Time prescriber validation system, and other control functions. Establish effective pre and post editing of pharmacy claims during real time adjudication. Evaluate third party payers, Medicare & Medicaid, for changes in policies and rules in billing pharmacy claims. If changes are identified, develop effective communication to instruct pharmacies on the proper billing procedures. Direct the execution of all internal controls (COSO/SOX) in department. Monitor the performance of various vendors that perform services for Rite Aid. Review and assess controls within the company’s NexGen dispensing system. Support inquiries on the company’s Prescription Monitoring Program. Supervisory Responsibilities This position directly supervises Business Analysts II, Data Integrity Analyst, and Document Administrator and carries out supervisory responsibilities in accordance with Rite Aid policies and applicable laws. Responsibilities include interviewing, hiring, training, directing, rewarding, and disciplining associates; appraising associate performance; and resolving complaints.
Experience / Requirements:
Other Skills, Abilities, and/or Training The following qualities are required:
Minimum age of 18 years old for business travel. Ability to pass drug test. Committed to providing customer service that makes both internal and external customers feel welcome, important, and appreciated. Ability to preserve confidentiality of information. Ability and willingness to move with purpose and a strong sense of urgency. Ability to work weekends on an occasional basis. Ability to work extended days on an occasional basis. Accuracy and attention to detail. Ability to organize and prioritize a variety of tasks/projects. Familiarity with industry/technical terms and processes. Ability to work within strict time frames and resolute deadlines. Typing speed of 60 WPM. Proficiency with the Microsoft ® Office Suite (Word, Excel, PowerPoint, and Access) The following qualities are helpful:
Ability to work day or evening hours. Ten-key punch speed of 4,000 SPH. Note : Products, software, and systems listed above are registered trademarks of their respective companies.
Certificates, Licenses, and/or Registrations This position requires the following:
Valid driver's license for daytime travel between various Rite Aid facilities. Active Pharmacist license in good standing for the state in which one works.
Education:
Bachelor's degree (BS), Doctoral degree (PHARM.D.), or equivalent in Pharmacy, plus five (5) years' experience in retail, and three (3) years’ experience working with pharmacy systems.
SUMMARY The primary purpose of this position is to oversee the company’s prescriber file, monitor and develop pharmacy claim edits, instruct pharmacies on the processing of third party claims, and reduce the number of audit chargebacks. Frequent independent judgments are essential. The incumbent is also required to perform all tasks in a safe manner consistent with corporate policies and state and federal laws.
ESSENTIAL DUTIES AND RESPONSIBILITIES The associate is responsible for the functions below, in addition to other duties as assigned:
Monitor the integrity of the company’s prescriber file through monitoring of the weekly prescriber validation system, Real Time prescriber validation system, and other control functions. Establish effective pre and post editing of pharmacy claims during real time adjudication. Evaluate third party payers, Medicare & Medicaid, for changes in policies and rules in billing pharmacy claims. If changes are identified, develop effective communication to instruct pharmacies on the proper billing procedures. Direct the execution of all internal controls (COSO/SOX) in department. Monitor the performance of various vendors that perform services for Rite Aid. Review and assess controls within the company’s NexGen dispensing system. Support inquiries on the company’s Prescription Monitoring Program. Supervisory Responsibilities This position directly supervises Business Analysts II, Data Integrity Analyst, and Document Administrator and carries out supervisory responsibilities in accordance with Rite Aid policies and applicable laws. Responsibilities include interviewing, hiring, training, directing, rewarding, and disciplining associates; appraising associate performance; and resolving complaints.
Experience / Requirements:
Other Skills, Abilities, and/or Training The following qualities are required:
Minimum age of 18 years old for business travel. Ability to pass drug test. Committed to providing customer service that makes both internal and external customers feel welcome, important, and appreciated. Ability to preserve confidentiality of information. Ability and willingness to move with purpose and a strong sense of urgency. Ability to work weekends on an occasional basis. Ability to work extended days on an occasional basis. Accuracy and attention to detail. Ability to organize and prioritize a variety of tasks/projects. Familiarity with industry/technical terms and processes. Ability to work within strict time frames and resolute deadlines. Typing speed of 60 WPM. Proficiency with the Microsoft ® Office Suite (Word, Excel, PowerPoint, and Access) The following qualities are helpful:
Ability to work day or evening hours. Ten-key punch speed of 4,000 SPH. Note : Products, software, and systems listed above are registered trademarks of their respective companies.
Certificates, Licenses, and/or Registrations This position requires the following:
Valid driver's license for daytime travel between various Rite Aid facilities. Active Pharmacist license in good standing for the state in which one works.
Education:
Bachelor's degree (BS), Doctoral degree (PHARM.D.), or equivalent in Pharmacy, plus five (5) years' experience in retail, and three (3) years’ experience working with pharmacy systems.