NCPDP Data Analyst

What you’ll do

In a few words…

Abarca is igniting a revolution in healthcare.  We built our company on the belief that with smarter technology we are redefining pharmacy benefits, but this is just the beginning.

The Network Strategy team has a multi-pronged approach to supporting Abarca’s many clients. They consult and create competitive pharmacy networks through leveraging pricing strategies and leading discussions via implementations. This team is also involved in re-contracting, re-implementing and all needs related to our clients throughout their time with Abara. Our Network Strategy team also establishes agreements, pricing schedules, contracting, and credentialing strategies with our networks to ensure proper accordance with any agreements as well as state and federal regulations across all lines of business. 

The NCPDP Data Analyst makes sure that crucial data received by the National Council for Prescription Drug Programs (NCPDP) is incorporated correctly in Abarca’s claim processing platform, Darwin, to support pharmacy network integrity and accurate prescription pricing and processing. They will also work towards achieving Network Strategy team’s interest in the initiatives to enhance the application of NCPDP data in claim processing, pharmacy network, and pricing logic. We’ll need the analyst to work on active participation in relevant network and pricing NCPDP work groups and updates to the claim processing standards and the creation and update of Abarca’s payer sheets. You’ll also support in a credentialing role by handling to applicable regulations and internal policies and procedures.

The fundamentals for the job…

• Serve as a subject matter expert (SME) of the NCPDP files received regularly to support ongoing pharmacy network integrity and credentialing.
• Monitor the NCPDP file process for updates requiring notification and/or action on behalf of Abarca or its clients.
• Troubleshoot inquiries from Abarca or its clients with potential root cause from NCPDP file updates.
• Represent the Network Strategy team in multi-department discussions on issues and opportunities to integrate data received from NCPDP into the pharmacy benefit and claim processing platform, Darwin, at the direction of the AVP of Network Strategy.
• Actively participate in relevant NCPDP work groups related to pharmacy network and prescription pricing while serving as representative of Network Strategy team during NCPDP standard update discussions and initiatives.
• Support payer sheet updates for new client implementations and updates to existing payer sheets to support processing initiatives.
• Reports weekly updates to the AVP of Network Strategy.
• Supports other credentialing analysts as needed through conducting ongoing credentialing and re-credentialing processes and ensures compliant and timely revision of all relevant applications.
• Reviews and ensures that all necessary licenses and credentials are verified and timely updated including contacting licensing boards, reviewing enrollment applications, and obtaining information directly from providers.

What we expect of you

The bold requirements…

• Associate’s or Bachelor’s Degree in a related field. (In lieu of a degree, equivalent relevant work experience may be considered.)
• 3+ years of active experience in working with NCPDP file updates in support of credentialing or pharmacy network management.
• Experience with developing and maintaining effective relationships with both internal and external business partners.
• Experience with Microsoft software applications, word processing, and spreadsheet applications.
• Experience applying attention to detail, analytical acumen, and critical thinking to supporting teams cross-functionally.
• Experience working within an environment that requires management of discrete tasks to meet specified deadlines, accurate and consistent management of data elements and/or audit function.
• Excellent oral and written communication skills. 
• Familiar with processing and reviewing NCPDP files

Nice to haves…

• Experience within Medicare Part D and Medicaid.

Physical requirements…

• Must be able to access and navigate each department at the organization’s facilities.
• Sedentary work that primarily involves sitting/standing.

At Abarca we value and celebrate diversity. Diversity, equity, inclusion, and belonging are guiding principles of Abarca and ensure Abarca’s workforce reflects the communities it serves.  We are proud to provide equal employment opportunities to all employees and applicants for employment and prohibit discrimination and harassment of any type without regard to race, color, religion, age, sex, national origin, disability status, medical condition, genetic information, protected veteran status, sexual orientation, gender identity or expression, or any other characteristic protected by federal, state, or local laws.

 Abarca Health LLC is an equal employment opportunity employer and participates in E-Verify.  “Applicant must be a United States’ citizen. Abarca Health LLC does not sponsor employment visas at this time”

 The above description is not intended to limit the scope of the job or to exclude other duties not mentioned. It is not a final set of specifications for the position. It’s simply meant to give readers an idea of what the role entails.

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