Pharmacy Clinical Operations - Remote Formulary Coding Project Coordinator vacancy at Aetna in Nashville

Aetna is employing Pharmacy Clinical Operations - Remote Formulary Coding Project Coordinator on Fri, 15 Mar 2013 10:23:14 GMT. This is a telework, work at home (WAH), position. Hours are 8AM-5:30PM or 9AM-6:30PM EST/CST.POSITION SUMMARY This position’s areas of responsibilities include project managing the implementation and on-going project management of Aetna''s National Formulary, Health Care Reform Exchange plans, and Pharmacy Clinical Programs. As a project coordinator/pharmacy technician, you will be part of the...

Pharmacy Clinical Operations - Remote Formulary Coding Project Coordinator

Location: Nashville Tennessee

Description: Aetna is employing Pharmacy Clinical Operations - Remote Formulary Coding Project Coordinator right now, this vacancy will be placed in Tennessee. For detail informations about this vacancy opportunity kindly see the descriptions. This is a telework, work at home (WAH), position. Hours are 8AM-5:30PM or 9AM-6:30PM EST/CST.POSITION SUMMARY This position’s areas of responsibilities include project managing the implementation and on-going project management of Aetna''s National Formulary, Health Care Reform Exchange plans, and Pharmacy Clinical Programs. As a project coordinator/pharmacy technician, you will be part of the Pharmacy Clinical Operations unit of pharmacists & other technicians, providing on-going support which includes: management, maintenance, Aetna’s National Formularies, Health Care Reform Exchange Formularies and benefits, UM Criteria, and Pharmacy Clinical Programs.

Responsibilities include:

• Provide technician support as part of a Pharmacy Clinical Operations team working with teams including Clinical Development, Manufacturer Contracting, Medical Management areas to maintain Aetna’s Formularies, Health Care Reform Exchange Formularies & plans, UM criteria, and pharmacy clinical programs;
• Maintain databases and on-going management and maintenance f! or Aetna’s Formularies, Health Care Reform Exchange Formular! ies, UM edits, benefit drug lists;
• Monitors and manages internal process and maintains case tracking tools. Completes required data input into performance measurement systems in support of key business and management initiatives.
• Assist pharmacists in preparing and maintaining clinical criteria to support the formulary, pharmacy UM edits programs. Assist as needed with maintenance criteria and communication letters of Pharmacy Prior Authorization system;
• Assist with projects, on-gong program processes, and streamlining work flows;
• Consults and communicates with internal depts regarding new business and revision activity in a timely manner.Required Experience: - Pharmacy Technician Certification, Nursing, or equivalent health care experience and licensure required (RN, LPN, or ChPT).
• Experience in managed care,Precertification, Formulary development,Formulary management and pharmacy coverage benefits, benefit installation and proc! esses required.
• Knowledgeable in Medicare Part D benefit and CMS regulations and how they relate to formulary management as a foundation to under the Health Care Reform Exchange Formularies and Pharmacy Clinical Programs.
• Proficiency in Microsoft Word.Experience in Microsoft Access and Microsoft Excel required.
• Can work with a sense of urgency in handling issues.
• Must be able to organize and manage multiple tasks. Ability to track on-going work/updates.
• Must be self-motivated and interested in learning new skills, use of new technologies.
• Ability to ask appropriate questions to obtain relevant information. Verbally present information in an organized, clear and articulate manner.
• Should have the ability to work independently and be pro-active in handling clinical operational issue, and demonstrate high productivity.
• Demonstrate project management experience. Project, program, and process management expe! rience required.
• Data interpretation and analysis experience.

EDUCATION
The highest level of education desired for candidates in this position is a Associate''s degree or equivalent experience.

LICENSES AND CERTIFICATIONS
Pharmacy/Pharmacy Technician (ChPT) is required
OR
Nursing/Registered Nurse (RN) is required
OR
Nursing/Licensed Practical Nurse (LPN) is required
Project Management/Project Management Certification (PMP) is desired

FUNCTIONAL EXPERIENCES
Functional - Project Management/Project Leader/1-3 Years
Functional - Project Management/Issue identification and analysis/1-3 Years
Functional -Clinical/Medical/Clinical claim review & coding/1-3 YearsFunctional - Medical Management/Clinical coverage and policies/1-3 Years

TECHNOLOGY EXPERIENCES
Technical - Aetna Applications/AetnaPharmacy Management Claim Adjudication Systems/1-3 YearsTechnical - Aetna Applications/Aetna Specialty Pharmacy/1-3 Years
Technical - Desktop Tools/Microsoft Project/1-3! Years
Please note that benefit eligibility may vary by position. Clickhereto review the benefits associated with this position.

Aetna does not permit the use of tobacco related products or drugs in the workplace.

Job Function: Management
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If you were eligible to this vacancy, please email us your resume, with salary requirements and a resume to Aetna.

If you interested on this vacancy just click on the Apply button, you will be redirected to the official website

This vacancy starts available on: Fri, 15 Mar 2013 10:23:14 GMT

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