Job Description

Exemption Status:

United States of America (Exempt)$83,426 - $114,712 - $145,997

“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.”

This position is not eligible for Sponsorship.

MedImpact Healthcare Systems, Inc. is looking for extraordinary people to join our team!

Why join MedImpact? 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 MedImpact, 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!

Serves as technical member of the client team. Ensures timely, accurate service delivery as liaison between assigned client(s), client team members, and IT staff.

Essential Functions and Responsibilities include the following. Other duties may be assigned.

• Collaborates with internal and external stakeholders to create best-in-class solutions that integrate technology, information, and business processes.
• Matches appropriate technology solutions to business needs. • Identifies, plans, develops, implements, and maintains business systems solutions that support client operational needs.
• Maintains current understanding of client file layouts, relationships, & logic and how they operate in MedImpact business applications. Provides technical consultation to the client team and related internal stakeholders.
• Writes detailed descriptions of user needs, program functions, and steps required to develop or modify business systems.
• Translates requirements into business, system & functional requirements and partners with IT Developers in translating requirements into design specifications.
• Develops queries to research, gather data and identify solutions.
• Performs various types of analysis related to business and system changes/enhancements (gap, impact, risk etc.).
• Actively participates in the creation and monitoring of service and trouble requests from creation to implementation.
• Creates and maintains related documentation/material pertinent to identified changes, such as work, data or process flows, analytical reports, decision support structures, use cases, as well as business rules, report design/mock-ups, etc. Ensures that the systems section of the client MedManual is current and properly documented
• Creates and maintains project plans including task identification, prioritization, and sequencing of project tasks, test plans, and user acceptance testing. Participates in developing and executing communication and training plans relevant to implemented changes.
• Utilizes planning, prioritizing, and organizational skills to ensure timely deliverables, high levels of quality, and efficient use of resources to achieve reporting timeliness and accuracy.

• Utilizes planning, prioritizing, and organizational skills to ensure timely deliverables, high levels of quality, and efficient use of resources to achieve reporting timeliness and accuracy.

• Maintains commitment to operational goals in the face of obstacles. Collaborates and cultivates positive relationships with internal and external customers through delivery of sustainable, measurable, accurate, reliable, and timely results that meet or exceed customer expectations. Promptly responds to service failures, resolves issues, and escalates concerns as appropriate.
• Promotes continuous improvement by ensuring adherence to quality principles. Seeks out and actively participates in business initiatives that contribute to service excellence.
• Actively participates in continued professional development to stay up to date on the latest technical and information management enhancements and data management best practices.

Supervisory Responsibilities

This job has 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; Respond promptly to client needs; Solicit client feedback to improve service; Respond to requests for service and assistance from clients; Meet commitments to clients; Manage difficult or emotional client situations.

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

Bachelor's degree from four-year college or university and three (3) to five (5) years of related experience required in Pharmacy Benefit Management (PBM), Pharmacy, Managed Healthcare or similar role; or an equivalent combination of education and experience.

Computer Skills

Strong proficiency with MS Office / Word, PowerPoint, Excel, Visio and Outlook to create complex documents, manage schedules, and analyze data. Business user of multiple software applications/processing systems. Working knowledge of key business application such as SQL coding, Oracle forms, Golden 32, MedOptimize, Visio, knowledgeable of UNIX operating systems.

Certificates, Licenses, Registrations

None currently required.

Other Skills and Abilities

Ability to effectively balance a high volume of work and a variety of tasks; ability to prioritize urgent issues effectively. Strong analytic, verbal and written communication skills. Detail-oriented with high degree of accuracy and organizational skills. Able to effectively work as a team player as well as independently Excellent investigative, problem resolution, judgment and decision- making skills required. Excellent presentation and consultative skills, working with internal and external clients at various levels in the organization.

Reasoning Ability

Ability to solve practical problems and deal with a variety of concrete variables in situations where only limited standardization exists. Ability to interpret a variety of instructions furnished in written, oral, diagram, or schedule form.

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.

Language Skills

Ability to read, analyze, and interpret general business periodicals, professional journals, technical procedures, or governmental regulations. Ability to write reports, business correspondence, and procedure manuals. Ability to effectively present information and respond to questions from groups of managers, clients, customers, and the general public.

Responsible for maintaining an effective compliance program by managing and overseeing MedImpact’s regulatory compliance activities and compliance with comprehensive federal and state laws, and regulations. This position manages requests and inquiries received from clients, regulatory authorities, and internal customers relating to MedImpact’s federal and state reviews/assessments, regulatory compliance initiatives, and related processes.

This position advises internal business partners on changing laws and regulations and maintains an effective communication program and record keeping mechanism for government regulations as required by various government regulatory agencies.

Essential Duties and Responsibilities

• Monitor state and federal regulations, sub-regulatory guidance, and any other applicable communications distributed by regulatory bodies.
• Analyze information for dissemination to appropriate internal operational areas and, where appropriate, prepare overviews and other documentation to serve as compliance guidance in relation to implementation of specified requirements. Interfaces with internal operational areas on compliance matters impacting MedImpact’s initiatives.
• Oversee internal implementation efforts relating to new legislation in concert with the Counsel, Legislative Services. Communicates to appropriate business units to ensure modifications are implemented as appropriate to ensure organization meets state and federal regulatory requirements
• Manage state regulatory reporting for initial and updated reporting and submission requirements. Work with internal subject matter experts, licensing, and outside counsel as appropriate.
• Develop documentation on best practice and establish ongoing processes and parameters to fully support the initial regulatory reporting and overall client support of regulatory reporting requests.
• Develop and maintain state regulatory reporting repository (PBMSource) and C360 and serve as subject matter expert for applicability, scope, and reporting parameters according to state regulatory requirements.
• Independently interface with clients and legal counsel on matters relating to compliance with applicable laws or regulations with standard summaries and potential challenges.
• Assist with the development and review of organization’s policies and procedures in relation to state or federal regulations. Identifies needed policies and procedures in order to demonstrate compliance with applicable requirements and works with appropriate internal operational units to ensure creation and maintenance of needed documentation. Ensure policies and procedures are revised to address regulatory changes.
• Work directly with the Compliance Officer to support the Corporate Compliance Program in relation to new or amended requirements.
• Manage various organizational committees and/or work groups to disseminate federal and state compliance information. Maintains records, as appropriate, to memorialize decisions, direction, actions, and ensures information is retrievable.
• Communicate to appropriate business units to ensure modifications are implemented as appropriate to ensure organization meets state and federal regulatory requirements.
• Keep up to date on the industry’s best practices and regulatory changes through PCMA and PBMSource.
• Lead and manage complex organizational corporate projects. (examples – NQTL, Website Accessibility, Consumer Protection Act)
• Develop and present training to departments across the organization in relation to enacted state or federal laws that impact multiple lines of business and presents updates on initiatives to the Corporate Compliance Committee.
• Development and implementation of strategic initiatives relating to emerging state and federal regulations.

Education and/or Experience

Level I

BS/BA and 3+ years’ experience or equivalent combination of education and experience

Level II

BS/BA and 5+ years’ experience or equivalent combination of education and experience, and 2 years' of SME in respective areas

Level II

BS/BA and 7+ years’ experience or equivalent combination of education and experience, and 4 years' of SME in respective areas

Computer Skills

Strong PC skills in Microsoft Office Suite, MS Outlook, and intermediate knowledge of Excel. Familiar with relational databases and industry specific software.

Certificates, Licenses, Registrations

None required

Other Skills and Abilities

• Solid working knowledge of current assigned state and federal regulatory requirements and related company training initiatives required.

• Strong listening skills and ability to convey regulatory compliance information, verbally and in writing, in an easy to understand format to employees of organization.

Reasoning Ability

Level I

• Ability to solve practical problems and deal with a variety of concrete variables in situations where only limited standardization exists.

• Ability to apply common sense understanding to carry out detailed but uninvolved written or oral instructions. Ability to deal with problems involving a few concrete variables in standardized situations.

Level II

Level I plus:

• Ability to interpret a variety of instructions furnished in written, oral, diagram, or schedule form.

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

Level III

Level II plus:

• Ability to apply principles of logical or scientific thinking to a wide range of intellectual and practical problems.

• 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 add, subtract, multiply, and divide in all units of measure, using whole numbers, common fractions, and decimals. Ability to compute rate, ratio, and percent and to draw and interpret bar graphs.

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

Language Skills

Level I

• Ability to read and interpret documents such as safety rules, operating and maintenance instructions, and procedure manuals.

• Ability to respond to common inquiries or complaints from customers, regulatory agencies, or members of the business community.

Level II

Level I plus:

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

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

Level III

Level II plus:

• Ability to read, analyze, and interpret the most complex documents.

• Ability to effectively present information to top management, public groups, and/or boards of directors.

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; use hands to manipulate a mouse, use a computer, speak or hear. The employee is occasionally required to stand; walk and reach with hands and arms. The employee must occasionally lift and/or move up to 10 pounds. Specific vision abilities required by this job include close vision, distance vision, depth perception and ability to adjust focus.

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. The noise level in the work environment is usually quiet. The position will be remote and based from San Diego with some flexibility for occasional in office work.

Working Hours

This is an exempt level position requiring an employee to work the hours needed to get the job done. Therefore one must have the flexibility to work beyond traditional hours and be able to work nights, weekends or on holidays as required. This may be changed from time to time to meet the needs of the business. Typical core business hours are Monday through Friday from 8:00am to 5:00pm.

Travel This position may require domestic travel and attendance maybe required at various local conferences and meetings. Approximately 20% of the time.

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.