Pharmacy Compliance Coordinator Job in Albany 12206, New York US
Responsible for the auditing, monitoring and oversight of the following items:
- Appropriate determination, coverage and reconciliation of Hospice-covered versus plan-covered medications
- Appropriate determination, coverage and reconciliation of medications for patients residing in Long-term Care settings
- Appropriate determination, coverage and reconciliation of Medicare Part B vs. Part D coverage of medications for ESRD patients
- Facilitation and execution of a pharmacy audit plan
In addition to the above, the position will work with cross-functional areas and the Pharmacy Benefit Manager in the identification, analysis, reconciliation and recoupment (if applicable) of incorrectly processed and/or inappropriately paid pharmacy claims.
QUALIFICATIONS:
- Bachelor's Degree required. Significant, relevant work experience (7 to 10 years) may be substituted for degree requirements.
- Certified Pharmacy Technician preferred.
- Pharmacy Technician with substantial pharmacy experience will be considered.
- Candidate should possess a background in pharmacy or applicable healthcare setting or an coordinator with healthcare/pharmacy experience required. Experience with CMS regulatory requirements preferred.
- Knowledge of CMS Regulatory requirements regarding Hospice, LTC, ESRD benefit coverage preferred.
- Demonstrated knowledge/proficiency of various systems applications including Facets, Excel, Word, and Access required. Familiarity with analytical tools and pharmacy software preferred.
- Experience with performing quality reviews and/or audits required.
Please visit www.cdphptalent.com to apply and to learn more about career opportunities with CDPHP.
CDPHP offers a competitive compensation and benefits package, including a 401(k) plan, tuition reimbursement, on-site fitness center, community involvement opportunities, along with an environment that promotes growth and professional development.
Equal Opportunity Employer M/F/D/V
January 26, 2011
• Tags: New York Us, Pharmacy Compliance Coordinator Job in Albany 12206 • Posted in: General