Job Summary
A company is looking for a Prescription Plan Design & Escalations Analyst.
Key Responsibilities:
- Analyze prescription benefit plan design within claims processing systems for quality and accuracy
- Monitor, investigate, and resolve reported system issues related to plan setup
- Serve as an escalation point for complex member and provider issues related to pharmacy benefits
Required Qualifications:
- Strong analytical skills with critical thinking capabilities
- Proficiency with Microsoft Excel and other spreadsheet software
- Ability to work effectively under close supervision and as part of a team
- Experience with Pharmacy Benefit Manager (PBM) claims systems is preferred
- Background in healthcare, particularly with medical or pharmacy claims is advantageous
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