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OPERATIONS

OPEN POSITIONS
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WE ARE THE FUEL THAT KEEPS THE ENGINES OF ABARCA RUNNING!

We make sense of a complex healthcare system, constantly pursuing new concepts and innovative ideas. In short, we make things happen and have fun doing it!

WHAT WE DO

SERVICE OPERATIONS

  • Manage pharmacy networks and all customer service functions for pharmacies, physicians and beneficiaries/members.
  • Provide strategic direction, key programs, and continuous updates to ensure a high quality of service to clients.
  • Oversight of pharmacy networks to comply with CMS Network and Member.

CLINICAL SERVICES

  • Evaluate coverage determination requests.
  • Develop and execute clinical programs.
  • Educate clients and pharmacies on new drugs approved and other clinical happenings.
  • Support clients in all clinical-related activities and requests.

QUALITY

  • Monitor that claims are adjudicating according to the client’s requirements.
  • Document, communicate, and coordinate resolution and preventive measures of any claim issues identified through claims monitoring or reported by client, member or other Abarca department.
  • Perform configuration testing, and lead the defect management process during a new client implementation to ensure a successful go-live.

DARWIN CONFIGURATION & IMPLEMENTATION

  • Manage benefits, formulary and/or network requirements.
  • Configure requirements in the PBM platform.
  • Fully validate and test configured requirements.
  • Actively participate as new enhancements affecting configuration arise.
OPENINGS in Operations
JOB OPENINGS

“When Abarcans say we’re LIKE FAMILY, we truly are. We put our values in action every day at Abarca. It’s easy for me to think of the people I work with as family, I care about my team on a personal level and make sure to always check in with them to know how they’re feeling beyond work. This is called living Like Family.”

DAWN GRAESE

QUALITY ASSURANCE SENIOR ANALYST

Abarcan Since 2018

LEARN MORE & APPLY TODAY!