Kaiser Permanente Network Pharmacy Benefits Analyst in SEATTLE, Washington

Title: Network Pharmacy Benefits Analyst Location: WA - Seattle-Renton-GH Campus - Southeast Job Number: 172458

At Kaiser Permanente, the Network Pharmacy Benefits Analyst acts as a subject matter expert and key point of contact for pharmacy benefit configurations. Provides technical assistance to statewide retail contracted pharmacies and internal staff to ensure accurate and consistent pharmacy claim adjudication. Serves as a facilitator to assure coordination and integration of all assigned work processes. Maintains the benefit structures and edits for all lines of business in the various PBM and provider network systems. Identifies areas for standardization and process improvement and assists in the documentation of these items. Collaborates with membership and billing staff to ensure accurate adjudication of pharmacy benefits and participates in pharmacy claim audits. Qualifications: Education Minimum Education Requirements Bachelor’s Degree in Business, Computer Science or related field or equivalent work experience. OR An equivalent of a Bachelor’s Degree and at least two years of progressively responsible relevant experience in claims, customer service, membership, configuration or other health plan functions requiring an in-depth knowledge of RxClaim systems.

Preferred Education Bachelor’s Degree in Business, Computer Science or related field or equivalent work experience. OR An equivalent of a Bachelor’s Degree and at least three years of progressively responsible relevant experience in claims, customer service, membership, configuration or other health plan functions requiring an in-depth knowledge of Epic, Lotus Notes, RxClaim systems.

Knowledge/Skills Minimum Knowledge/Skills Requirements Intermediate skills in working with computers and MS office products. Skilled at multitasking and can manage working in a fast-paced environment. Strong interpersonal, problem-solving and collaboration skills. Strong verbal and written communications skills needed. Skilled in using independent judgment to accurately analyze situations and develop the best solution.

Preferred Knowledge/Skills Advanced skills in working with computers and MS office products. Skilled at multitasking and can manage working in a fast-paced environment. Strong interpersonal, problem-solving and collaboration skills. Strong verbal and written communications skills needed. Skilled in using independent judgment to accurately analyze situations and develop the best solution. Knowledge of benefit adjudication processes. Experience Minimum Experience Requirements 2 years of relevant work experience with drug formulary in a retail pharmacy setting or experience with health plan, IT, claims, customer service, membership, configuration or other areas of a large, complex health care or insurance provider.

Preferred Experience 3 years of relevant work experience with drug formulary in a retail pharmacy setting or experience with health plan, IT, claims, customer service, membership, configuration or other areas of a large, complex health care or insurance provider. Experience working with a Pharmacy Benefits Manager.

License/Certifications Minimum License/Certifications Requirements At time of hire - Washington State Pharmacy Technician License OR thorough knowledge of generic/trade drug names, uses and categories with in depth understanding of a formulary, insurance, and/or medical terminology.

Preferred License/Certifications None Required

External hires must pass a background check/drug screen. Qualified applicants with arrest and/or conviction records will be considered for employment in a manner consistent with Federal, state and local laws, including but not limited to the San Francisco Fair Chance Ordinance. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, national origin, sexual orientation, gender identity, protected veteran, or disability status. Job: Pharmacy Bargaining Unit: WWA Admin NonExempt (non-union) FTE: 1 Schedule: Full-time Shift: Day Job Days of shift: M-F Hours of shift: 8am-6pm (variable) Travel: No Job level: Individual Contributor Job type: Standard Employee status: Regular J2W code: HLTHPD

External hires must pass a background check/drug screen. Qualified applicants with arrest and/or conviction records will be considered for employment in a manner consistent with Federal, state and local laws, including but not limited to the San Francisco Fair Chance Ordinance. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, national origin, sexual orientation, gender identity, protected veteran, or disability status.