Support pharmacy benefit administration by troubleshooting benefit setup, reviewing formulary/benefit configurations, conducting claims analysis, managing ticketed work, and ensuring compliance and accurate program maintenance.

The Clinical Review Clinician resolves appeals by reviewing medical records, ensuring compliance with standards, and communicating with stakeholders. They prepare case reviews and work with leadership to improve processes.

Design, build, test and maintain technology and process solutions to improve business processes, focusing on complex applications. Engage with users to identify needs and document procedures.