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Drug File Coordinator

Job Description

KEPRO is a rapidly growing national quality improvement and care management organization. We work to ensure that over 20 million people receive the right care, at the right time, in the right setting. KEPRO is seeking resumes for a highly experienced professional.

Drug File Coordinator

Summary Description

This position will act as a drug file coordinator.  The Coordinator will also provide administrative support when needed. Requires a range of skills and knowledge of organizational policies and procedures. Work will be performed under minimal supervision and requires independent judgment and discretion.


Accountabilities

  • Monitor and maintain the drug pricing file, including but not limited to receiving and disseminating weekly drug file, making system updates based on weekly file updates, communicating both orally and in written form with providers and outside contractors.
  • Monitor, oversee, and update the HCPCS/JCode drug file/program to include but not limited to routine pricing updates, fee schedule review, file maintenance, annual review of new HCPCS, utilization audits, administrative reviews/appeals, and assist providers, agency staff, drug manufacturers, and outside contractors with claim adjudication issues.
  • Provide administrative support and phone coverage back-up to pharmacy administrative services staff as needed.
  • Attend and participate in Medicaid related meetings upon request.
  • Respond to provider/recipient inquiries via written, verbal, or electronic means.
  • Conduct/review query analysis as needed.
  • Provide clinical support to the staff pharmacist as needed.
  • Research proposed cost savings as needed.
  • Assist with drug utilization review meetings and projects.
  • Assist with program audits and pharmacy lock-in updates as needed.
  • Update hemophilia factor product prices and conduct hemophilia utilization query, cost savings report, and audits quarterly.
  • Review the semi-annual average acquisition rebase and provide feedback as needed.
  • Monitor weekly data warehouse newsletters and editorial highlights and recommend drug file/policy changes as needed.

The list of accountabilities is not intended to be all-inclusive and may be expanded to include other duties that management may deem necessary from time to time

Qualifications

  • Minimum of a bachelor’s degree
  • Nationally certified pharmacy technician in good standing with the Alabama State Board of Pharmacy

Knowledge, Skills, Abilities

  • Excellent organizational, verbal/written communications and interpersonal relationship skills essential.
  • Ability to handle multiple projects and set priorities.
  • Proficiency in Microsoft Office software applications.
  • Ability to interact with various levels of personnel, both clinical and non-clinical.
  • Knowledge and understanding of medications and medical terminology

Experience

  • Minimum of 3 years of experience in outpatient/community pharmacy

Mental and Physical Requirements

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 will be made as required by law in an attempt to enable an individual with a disability to perform the essential functions of this job. While performing the duties of this job, the employee is regularly required to sit for prolonged periods of time; key and/or control objects; interact extensively with internal and external customers; occasionally lift and/or move objects weighing up to 10 pounds; and occasionally travel within the state.

KEPRO offers challenging careers, excellent benefits and opportunities for advancement.  For consideration, please submit resume and cover letter with salary requirements. Only those candidates identified for an interview will be contacted. No Phone Calls Please.  Visit our website at www.KEPRO.com for more information on the KEPRO Family of Companies.   


EOE AA M/F/Vet/Disability

KEPRO is an E-Verify employer. E-Verify is an internet based system operated by the Department of Homeland Security (DHS) in partnership with the Social Security Administration (SSA) that allows participating employers to electronically verify the employment eligibility of their newly hired employees in the United States.

Equal Opportunity Employer/Protected Veterans/Individuals with Disabilities

The contractor will not discharge or in any other manner discriminate against employees or applicants because they have inquired about, discussed, or disclosed their own pay or the pay of another employee or applicant. However, employees who have access to the compensation information of other employees or applicants as a part of their essential job functions cannot disclose the pay of other employees or applicants to individuals who do not otherwise have access to compensation information, unless the disclosure is (a) in response to a formal complaint or charge, (b) in furtherance of an investigation, proceeding, hearing, or action, including an investigation conducted by the employer, or (c) consistent with the contractor’s legal duty to furnish information.

Job Requirements

See job description

Job Snapshot

Location US-AL-Montgomery
Employment Type Full-Time
Pay Type Hour
Pay Rate N/A
Store Type Health Care
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Company Overview

KEPRO

Evolving intelligence with timeless values.Since 1985, KEPRO has helped over 1 billion members lead healthier lives through clinical expertise, integrity and compassion. Our values are promises we keep every day. And why we keep growing with our clients. Learn More

Contact Information

US-AL-Montgomery
Snapshot
KEPRO
Company:
US-AL-Montgomery
Location:
Full-Time
Employment Type:
Hour
Pay Type:
N/A
Pay Rate:
Health Care
Store Type:

Job Description

KEPRO is a rapidly growing national quality improvement and care management organization. We work to ensure that over 20 million people receive the right care, at the right time, in the right setting. KEPRO is seeking resumes for a highly experienced professional.

Drug File Coordinator

Summary Description

This position will act as a drug file coordinator.  The Coordinator will also provide administrative support when needed. Requires a range of skills and knowledge of organizational policies and procedures. Work will be performed under minimal supervision and requires independent judgment and discretion.


Accountabilities

  • Monitor and maintain the drug pricing file, including but not limited to receiving and disseminating weekly drug file, making system updates based on weekly file updates, communicating both orally and in written form with providers and outside contractors.
  • Monitor, oversee, and update the HCPCS/JCode drug file/program to include but not limited to routine pricing updates, fee schedule review, file maintenance, annual review of new HCPCS, utilization audits, administrative reviews/appeals, and assist providers, agency staff, drug manufacturers, and outside contractors with claim adjudication issues.
  • Provide administrative support and phone coverage back-up to pharmacy administrative services staff as needed.
  • Attend and participate in Medicaid related meetings upon request.
  • Respond to provider/recipient inquiries via written, verbal, or electronic means.
  • Conduct/review query analysis as needed.
  • Provide clinical support to the staff pharmacist as needed.
  • Research proposed cost savings as needed.
  • Assist with drug utilization review meetings and projects.
  • Assist with program audits and pharmacy lock-in updates as needed.
  • Update hemophilia factor product prices and conduct hemophilia utilization query, cost savings report, and audits quarterly.
  • Review the semi-annual average acquisition rebase and provide feedback as needed.
  • Monitor weekly data warehouse newsletters and editorial highlights and recommend drug file/policy changes as needed.

The list of accountabilities is not intended to be all-inclusive and may be expanded to include other duties that management may deem necessary from time to time

Qualifications

  • Minimum of a bachelor’s degree
  • Nationally certified pharmacy technician in good standing with the Alabama State Board of Pharmacy

Knowledge, Skills, Abilities

  • Excellent organizational, verbal/written communications and interpersonal relationship skills essential.
  • Ability to handle multiple projects and set priorities.
  • Proficiency in Microsoft Office software applications.
  • Ability to interact with various levels of personnel, both clinical and non-clinical.
  • Knowledge and understanding of medications and medical terminology

Experience

  • Minimum of 3 years of experience in outpatient/community pharmacy

Mental and Physical Requirements

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 will be made as required by law in an attempt to enable an individual with a disability to perform the essential functions of this job. While performing the duties of this job, the employee is regularly required to sit for prolonged periods of time; key and/or control objects; interact extensively with internal and external customers; occasionally lift and/or move objects weighing up to 10 pounds; and occasionally travel within the state.

KEPRO offers challenging careers, excellent benefits and opportunities for advancement.  For consideration, please submit resume and cover letter with salary requirements. Only those candidates identified for an interview will be contacted. No Phone Calls Please.  Visit our website at www.KEPRO.com for more information on the KEPRO Family of Companies.   


EOE AA M/F/Vet/Disability

KEPRO is an E-Verify employer. E-Verify is an internet based system operated by the Department of Homeland Security (DHS) in partnership with the Social Security Administration (SSA) that allows participating employers to electronically verify the employment eligibility of their newly hired employees in the United States.

Equal Opportunity Employer/Protected Veterans/Individuals with Disabilities

The contractor will not discharge or in any other manner discriminate against employees or applicants because they have inquired about, discussed, or disclosed their own pay or the pay of another employee or applicant. However, employees who have access to the compensation information of other employees or applicants as a part of their essential job functions cannot disclose the pay of other employees or applicants to individuals who do not otherwise have access to compensation information, unless the disclosure is (a) in response to a formal complaint or charge, (b) in furtherance of an investigation, proceeding, hearing, or action, including an investigation conducted by the employer, or (c) consistent with the contractor’s legal duty to furnish information.

Job Requirements

See job description

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