Health Plan Pharma Coverage Analyst
Database Building through scanning of Health insurance companies Policies, Formulary and prior authorization (PA) forms.
The profile would also involve tracking any changes in the coverage of the healthcare plans in terms of drugs being covered
ESSENTIAL DUTIES AND RESPONSIBILITIES
Internet searching on an individual health plan's web site for documents namely a formulary and a prior authorization data for drugs covered in the plan
Duties would involve regularly determining specific data points for a drug, sometimes for multiple approved uses of a single drug and determining if a change has occurred from the previous search of the payers website
The analyst would need to record any changes with respect to the drugs and these data points by entering those criteria into a standardized database using a data dictionary that varies by drug and requires both clinical and US managed care knowledge
The analyst would be responsible for the first round of quality control for language, data dictionary adherence and correct interpretation
We are a reputed $500 million US based multinational Technology-Enabled Business Process... Outsourcing (BPO) company specializing in Integrated BPO solutions across the front and back office that support the entire lifecycle of our client and customers.
With our headquarter in Rochester, New York, Sutherland now employs over 30,000 professionals offering blended services from its 33 delivery centers in Bulgaria, Canada, India, Mexico, Philippines, the United Arab Emirates, the United Kingdom, and the United States. Read full description