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Pharmacy Benefits Specialist, Medicare II - Akron, OH

Company: SummaCare
Job type: full-time
Category: Research

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Job description

SummaCare, Inc., a regional health insurance company based in Akron, Ohio, is looking for an individual to serve as a Subject Matter Expert (SME) for Medicare pharmacy benefit questions, concerns, and issues from internal and external customers. The selected candidate would support new benefit design, benefit build, testing, and implementation of market competitive, cost effective, quality based drug benefits which meet applicable federal and state regulatory requirements.

Essential Functions and Responsibilities- Monitors and provides oversight of PBM activities.
- Designs, builds and implements new Medicare Pharmacy benefits with the Pharmacy Benefits Manager (PBM).
- Implements Medicare Pharmacy regulatory changes.
- Serves as Subject Matter Expert (SME) for the Medicare pharmacy benefits and Medicare drug medical benefits.
- Attends and participates in meetings with internal and external customers as it relates to Medicare Part D.
- Coordinates all delegated activities to the PBM.

Educational Requirements

High school diploma/GED required.

Required Experience

2 years performing same or similar responsibilities. Relevant experience includes: Medicare experience working in a health plan or Pharmacy Benefit Manager (PBM).

Required Licenses and/or Certificates

Certified Pharmacy Technician (CPhT) (must be met within 12 months from date of hire).

SummaCare is proud to be a Tobacco-Free Company. Applicants who test positive for nicotine during pre-employment testing are not eligible for hire.

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