Healthcare Program Associate

Albany, NY, USA

Req #640

Monday, September 9, 2024

Staffing Solutions Organization LLC (SSO), an affiliate of Public Consulting Group LLC (PCG), is focused on delighting clients with world-class managed staffing and talent consulting services. SSO is committed to a diverse workforce, which is a reflection of our clients and the people they serve.

Healthcare Program Associate – Albany, NY

DPDM - 1209

Summary

· Producing and evaluating Quality Assurance reports using the Medicaid Data Warehouse (MDW) on a regular basis

· Reviewing Program communications, reports and website for accuracy

· Reviewing requests for prior authorization of Long Term Care pharmacy claims

· Processing prior authorizations according to policies and procedures

· Communicating program policy and procedures to external stakeholders to aid in adjudication of pharmacy claims

· Ensuring vendor remote calls are following procedures

· Draft stakeholder communications on program updates for the Medicaid Update or pharmacy notification system.

Basic Qualifications:

· Associate degree with at least 6 months of healthcare experience

· Must be a United States Citizen or a Permanent Resident of the United States in order to be considered

Desired Characteristics:

· Possess a professional approach to all aspects of their work

· Ability to effectively communicate verbally and in writing with internal and external stakeholders

· Have strong writing and organizational skills; be able to multitask and deliver on tight timeframes

· Ability to work collaboratively with co-workers and be self-motivated.

Preferred candidates will have:

· Experience performing administrative and clerical tasks, handling phone inquiries and interpreting and providing guidance on policy.

· Experience using Microsoft applications including Outlook, Word and Excel and have the ability to analyze basic data.

· Experience in performing administrative and routine clerical tasks, organizing, and managing files, supporting other staff members with organizational tasks

· Ability to provide assistance to phone inquiries and emails

· Ability log and maintain reporting of such per the processes provided.

· Ability to make sophisticated judgements concerning Pharmacy Policy as provided in Manuals and guidance.

Compensation for roles at Staffing Solutions Organization LLC (SSO) varies depending on a wide array of factors including, but not limited to, the specific office location, role, skill set, and level of experience. As required by applicable law, SSO provides a reasonable range of compensation for this role. In addition, SSO provides a range of benefits for this role.

All qualified applicants will receive consideration for employment without regard to race, color, religion, gender, sexual orientation, gender identity, marital status, age, national origin, protected veteran status, or disability. Staffing Solutions Organization LLC is an e-Verify participant.

Other details

• Pay Type Hourly

• Min Hiring Rate $19.00

• Max Hiring Rate $22.00

• Telecommute % 50

• Required Education Equivalent Experience

• Job Start Date Friday, March 1, 2024

• Albany, NY, USA

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