Aetna Quality Analyst in Phoenix, Arizona
Req ID: 41062BR
This is an office based role in Phoenix, AZ.
The Quality Analyst position supports the Medicaid Formulary team. This role supports both the Medicaid and MMP/DSNP lines of business. Primary duties include P&T Committee support, Formulary submission and installation. In addition this role is responsible for verifying quality of the formulary through the validation and audit process. This role is responsible for other duties as assigned.
Specific roles and responsibilities include but are not limited to:
MMP and Medicaid Formulary Support including Formulary Development and Maintenance support, HPMS formulary file creation and QC, MMP ADD file creation and QC, Adjudication files creation and QC, Formulary database maintenance support, Formulary installation form creation and QC, Medicare PA and ST file creation, Daily Medispan release tracking, Provide ad hoc formulary analysis support, Monthly formulary update documents creation, Ad hoc formulary testing QC and Submit PBM Formulary requests.
P&T Support including P&T minutes, P&T and subcommittee (Drug Coverage Committee) administrative Support, Member material distribution, Order lunch for monthly P&T, Submit reimbursement for voting members for P&T and DCC meetings and other administrative duties.
Other duties may include Project management support and contribution to policy & procedure development as well as process and desktop documents.
-A national pharmacy technician certification is required (CPhT)
-5+ years Registered Pharmacy Technician is required
-3+ years of Formulary Management/UM Experience is required
-3+ years QA/QC Experience
-3+ years Project Management Experience preferred
-3+ years of Formulary System Experience preferred
The minimum level of education desired for candidates in this position is a High School diploma, G.E.D. or equivalent experience.
LICENSES AND CERTIFICATIONS
Pharmacy/Pharmacy Technician is required
Project Management/Project Management Certification is desired
Medical Management - Pharmacy/4-6 Years
Medical Management - Quality Management/1-3 Years
Project Manager/1-3 Years
Microsoft Outlook/4-6 Years
Microsoft Word/4-6 Years
Microsoft Project/1-3 Years
Microsoft Visio/1-3 Years
Full-Time Telework (WAH) potential, Option for telework will be evaluated after a certain period of employment
ADDITIONAL JOB INFORMATION
Aetna is about more than just doing a job. This is our opportunity to re-shape healthcare for America and across the globe. We are developing solutions to improve the quality and affordability of healthcare. What we do will benefit generations to come.
We care about each other, our customers and our communities. We are inspired to make a difference, and we are committed to integrity and excellence.
Together we will empower people to live healthier lives.
Aetna is an equal opportunity & affirmative action employer. All qualified applicants will receive consideration for employment regardless of personal characteristics or status. We take affirmative action to recruit, select and develop women, people of color, veterans and individuals with disabilities.
We are a company built on excellence. We have a culture that values growth, achievement and diversity and a workplace where your voice can be heard.
Benefit eligibility may vary by position. Click here to review the benefits associated with this position.
Aetna takes our candidate's data privacy seriously. At no time will any Aetna recruiter or employee request any financial or personal information (Social Security Number, Credit card information for direct deposit, etc.) from you via e-mail. Any requests for information will be discussed prior and will be conducted through a secure website provided by the recruiter. Should you be asked for such information, please notify us immediately.
Job Function: Quality Management