Providence Health & Services Business Analyses & Systems Coordinator in Beaverton, Oregon
Providence St. Joseph Health is calling a Business Analyses & Systems Coordinator to our location in Beaverton, OR.
We are seeking a Business Analyses & Systems Coordinator to design, develop, and execute the business requirements necessary to assure the accurate processing of prescription claims at participating pharmacies utilizing eligibility, benefits, formularies and drug utilization management edits in a point-of service environment. This requires coordination between internal departments and contracted vendors and interpretation of regulatory requirements.
In this position you will have the following responsibilities:
Required to assess and determine key attributes of pharmacy claims systems and other software utilized in the pharmacy department necessary to develop and execute tools that take into consideration the unique needs of individuals at various stages of life from the neonate to the geriatric member and throughout the continuum.
Coordinates systems configurations and maintenance of systems with contracted vendor for pharmacy claims for all lines of business.
Coordinates implementations of formulary and utilization management decisions.
Evaluates the return of paid pharmacy claims to PHP. Remediates discrepancies for all lines of business and assures that records and adjustments are managed according to regulatory requirements.
Coordinates system impact of new pharmacy products, network contract administration, implementation of state and federal mandates, software upgrades, operational workflow discussions, and benefit structural decisions.
Required qualifications for this position include:
Bachelor's Degree in Business Administration, Healthcare Administration or Healthcare related field or 4 years additional experience as a Pharmacy Technician or a related healthcare field.
Medication and drug product category training and medical terminology.
5 years experience as a Pharmacy Technician or directly related field.
1 year Managed care pharmacy experience.
Licensure in Oregon as a Pharmacy Technician and National Certification as Pharmacy Technician within one year of employment.
Preferred qualifications for this position include:
Project management, Six Sigma Change Acceleration Process (CAP), LEAN, and Work Out training.
Project management, Six Sigma Change Acceleration Process (CAP), LEAN, and Work Out experience.
About Providence in Oregon.
As the largest healthcare system and largest private employer in Oregon, Providence offers exceptional work environments and unparalleled career opportunities.
The Providence Experience begins each time our patients or their families have an encounter with a Providence team member and continues throughout their visit or stay. Whether you provide direct or indirect patient care, we want our patients to feel that they are in a welcoming place where they can be comfortable and free from anxiety. Our employees create the Providence Experience through simple, caring behaviors such as acknowledging and welcoming each visitor, introducing ourselves and Providence, addressing people by name, providing the duration of estimated wait times and updating frequently if timelines change, explaining situations in a way that puts patients at ease, carefully listening to their concerns, and always thanking people for trusting Providence for their healthcare needs. At Providence, our quality vision is simple, "Providence will provide the best care and service to every person, every time."
Providence is consistently ranked among the top 100 companies to work for in Oregon. It is also home to two of our award-winning Magnet medical centers. Providence hospitals and clinics are located in numerous areas, ranging from the Columbia Gorge to the wine country to sunny southern Oregon to charming coastal communities to the urban setting of Portland. If you want a vibrant lifestyle while working with a team highly committed to the art of healing, choose from our many options in Oregon.
For information on our comprehensive range of benefits, visit:
As expressions of God’s healing love, witnessed through the ministry of Jesus, we are steadfast in serving all, especially those who are poor and vulnerable.
Providence Health & Services is a not-for-profit Catholic network of hospitals, care centers, health plans, physicians, clinics, home health care and services guided by a Mission of caring the Sisters of Providence began over 160 years ago. Providence is proud to be an Equal Opportunity Employer. Providence does not discriminate on the basis of race, color, gender, disability, veteran, military status, religion, age, creed, national origin, sexual identity or expression, sexual orientation, marital status, genetic information, or any other basis prohibited by local, state, or federal law.
Job Category: Financial Analyst
Req ID: 264784