Pharmacy Analyst I

Founded in 1977 as the Senior Care Action Network, SCAN began with a simple but radical idea: that older adults deserve to stay healthy and independent. That belief was championed by a group of community activists we still honor today as the "12 Angry Seniors." Their mission continues to guide everything we do.

Today, SCAN is a nonprofit health organization serving more than 500,000 people across Arizona, California, Nevada, New Mexico, Texas, and Washington, with over $8 billion in annual revenue. With nearly five decades of experience, we have built a distinctive, values-driven platform dedicated to improving care for older adults.

Our work spans Medicare Advantage, fully integrated care models, primary care, care for the most medically and socially complex populations, and next-generation care delivery models. Across all of this, we are united by a shared commitment: combining compassion with discipline, innovation with stewardship, and growth with integrity.

At SCAN, we believe scale should strengthen-not dilute-our mission. We are building the future of care for older adults, grounded in purpose, accountability, and respect for the people and communities we serve.

The Job

The Pharmacy Analyst I supports daily operational functions and oversight of the SCAN Pharmacy Benefit Management (PBM) company on delegated Part D activities. This role assists with maintaining compliance with Part D deadlines and regulatory timeframes. Under guidance, the Analyst I provides support in managing Eligibility files, Prescription Drug Event (PDE) data, Drug Plan Finder submissions, Financial Information Reporting, and other key functions to help ensure adherence to Medicare requirements.

You Will

• Serve as a subject matter expert for Part D Reporting requirements, Pharmacy Access Requirements, Prescription Drug Event data, Financial Information Reporting and Drug Plan Finder files by keeping up to date with Medicare requirements.

• Ensure eligibility and coordination of benefit files are sent to the PBM for processing and assess if file enhancements are needed. Ensure the PBM is processing Prescription Drug Events, Automated Claims Reprocessing and Financial Information Data according to CMS regulatory standards by conducting daily oversight. Ensure PBM oversight of claims adjudication and retrolics and ensure 1/1 Readiness related to eligibility.

• Analyze and monitor large data sets that are exchanged from SCAN to the PBM using a variety of reporting tools.

• Ensure audit documentation is prepared according to audit instructions and provided within the specified audit time frame. Prepare written responses or documentation for pharmacy audits.

• Perform routine monitoring to ensure Part D compliance and detect performance issues or operational gaps.

• Assist in the implementation, testing, and validation of pharmacy benefits to ensure accurate benefit configuration and claims adjudication.

• Collaborate with cross-functional teams, including Compliance, Product, and IT, to address issues and support PDE and other pharmacy initiatives.

• Identify and escalate issues related to pharmacy benefits, claims processing, and PDE submissions, working with the PBM and internal teams to resolve discrepancies.

• Maintain professional and technical knowledge by attending educational workshops; reviewing professional publications & CMS regulatory requirements; establishing personal networks; participating in professional societies.

• Contribute to the development, maintenance, and documentation of standard operating procedures (SOPs) and desktop procedures to support compliance and operational efficiency.

• We seek Rebels who are curious about AI and its power to transform how we operate and serve our members.

• Actively support the achievement of SCAN's Vision and Goals.

• Other duties as assigned.

Your Qualifications

• 0-3 years of related experience.

• High School Diploma or equivalent experience required.

• Bachelor's Degree or equivalent experience preferred.

• Expert knowledge of CMS Part D regulations e.g., CMS Call Letters, MA-PD application, PDE, LICS, Claims Processing, Part D Reports, FIR. Knowledge of PDE calculations that pertain to Enhance Alternative Plans, Coverage Gap, etc.

• Ability to prioritize workload to meet deadlines. Ability to multi-task in a fast pace environment. Ability to interact effectively and professionally with all levels of staff.

• Excellent grammar and writing skills. Excellent verbal skill sets to be able to communicate in conference calls and in large meetings. Team player with a strong work ethic.

• Self-starter that can take the lead on a project and manage its progress for completion. Detail oriented and is able to work with large data sets. Advanced skills with Microsoft Office (e.g., Word, Excel, Access, Outlook, and PowerPoint) and SQL. Familiarity with Tableau and Visio.

What's in it for you?

• Base salary range: $25.38 to $36.76 per hour

• Internal title: Pharmacy Analyst I

• Work Mode: Remote

• An annual employee bonus program

• Robust Wellness Program

• Generous paid-time-off (PTO)

• 11 paid holidays per year, plus 1 floating holiday, plus 1 birthday holiday

• Excellent 401(k) Retirement Saving Plan with employer match and contribution

• Robust employee recognition program

• Tuition reimbursement

• An opportunity to become part of a team that makes a difference to our members and our community every day!

We're always looking for talented people to join our team! Qualified applicants are encouraged to apply now!

At SCAN we believe that it is our business to improve the state of our world. Each of us has a responsibility to drive Equality in our communities and workplaces. We are committed to creating a workforce that reflects our community through inclusive programs and initiatives such as equal pay, employee resource groups, inclusive benefits, and more.

SCAN is proud to be an Equal Employment Opportunity and Affirmative Action workplace. Individuals seeking employment will receive consideration for employment without regard to race, color, national origin, religion, age, sex (including pregnancy, childbirth or related medical conditions), sexual orientation, gender perception or identity, age, marital status, disability, protected veteran status or any other status protected by law. A background check is required.

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Equal Opportunity Employer/Protected Veterans/Individuals with Disabilities

The contractor will not discharge or in any other manner discriminate against employees or applicants because they have inquired about, discussed, or disclosed their own pay or the pay of another employee or applicant. However, employees who have access to the compensation information of other employees or applicants as a part of their essential job functions cannot disclose the pay of other employees or applicants to individuals who do not otherwise have access to compensation information, unless the disclosure is (a) in response to a formal complaint or charge, (b) in furtherance of an investigation, proceeding, hearing, or action, including an investigation conducted by the employer, or (c) consistent with the contractor's legal duty to furnish information. 41 CFR 60-1.35(c)