The Regional Administrative Assistant III is selected by and reports to the Vendor Drug Field Pharmacist. This position provides moderately complex administrative/technical program assistance to the Vendor Drug Field Pharmacist. Work is performed under limited supervision, with extensive latitude for the use of initiative and independent judgment. The Administrative Assistant utilizes mainframe and LAN-based computer files and printouts for research and analysis of VDP claims. This position calculates and performs online, real-time claims adjustments recouping thousands of dollars per month back into the program. The Administrative Assistant responds to inquiries from staff, pharmacy providers, clients, physicians, staff and other outside parties regarding Medicaid, CHIP, Kidney Health Care, and Children with Special Healthcare Needs outpatient drug benefits.
The Administrative Assistant is the primary point of contact for clients and others who call on their behalf for assistance in accessing pharmacy benefits. This position is responsible for providing education to contracted pharmacy providers on Medicaid/CHIP, Kidney Health Care, and Children with Special Health Care Needs program policies and procedures, drug coverage, client eligibility and profile requests ensuring confidentiality.
Essential Job Functions:
1. Provides general administrative/technical support to the Field Pharmacist.
a. Composes, types, and prepares correspondence, reports, charts, documents, letters, and memos.
b. Completes and maintains automated Pharmacy Evaluation and Classification Reports and Drug Survey forms within prescribed time period.
c. Coordinates, files, organizes, and distributes documents related to program operations to support Field Pharmacist within a prescribed manner.
d. Monitors and maintains inventory of supplies and equipment within the prescribed time period.
e. Makes travel arrangements and prepares reimbursement vouchers according to policy.
f. Maintains a number of filing systems, both manual and electronic.
g. Maintains and protects confidential information.
h. Answers telephone, responds to inquiries from staff, provider pharmacies, doctors, nurses, nursing homes and others.
i. Completes assignments within prescribed timeframes.
j. Maintains current program knowledge in order to educate pharmacies and others to better ensure clients have access to covered services.
k. Escalates issues and trends effecting service delivery, fraud, and other important matters.
2. Researches and analyzes reports to determine which pharmacy claims require review/audit. Analyzes claim documents received from pharmacy providers to ensure contract compliance. Produces mail-outs requesting documentation from pharmacy providers. Tracks and maintains suspense dates on all correspondence requiring a response. Performs all research and analysis within prescribed time period.
3. Processes online, real-time claims adjustments utilizing DHS mainframe.
4. Responds to routine and non-routine inquiries from staff, clients, pharmacy providers, physicians, nursing homes, and other outside parties.
5. Performs other duties, as assigned and required to maintain VDP regional operations. Duties to be reviewed by supervisor and measured at time of completion.
Knowledge Skills Abilities:
Registration or Licensure Requirements:
- Knowledge of moderately complex administrative procedures.
- Ability to communicate effectively orally, in writing and on the telephone.
- Skill in preparing correspondence, reports, letters and memorandums.
- Ability to analyze and compile data and pay close attention to detail.
- Ability to manage multiple tasks and to work under pressure.
- Ability to establish and maintain effective working relationships with other employees. Ability to analyze and solve problems.
- Knowledge of the Medicaid Program, Vendor Drug Program, Children's Health Insurance Program, Kidney Health Care Program, and Children with Special Health Care Needs Program.
- Ability to understand and effectively interpret agency and program rules, policies, and procedures.
- Skill in the use of computer software, specifically Windows, WordPerfect, Microsoft Outlook, Word, and Excel.
- Ability to use tact, diplomacy, and maintain confidential information when dealing with clients and providers, staff, and outside parties.
- Ability to work under minimal supervision with considerable latitude for independent judgment. Ability to organize workload, set priorities and meet deadlines.
Initial Selection Criteria:
- Medicaid/Chip and Vendor Drug knowledge and experience preferred.
- Experience working full-time utilizing moderately complex administrative and technical skills.
- Ability to communicate effectively orally, in writing, and on the telephone.
- Experience in preparing correspondence, reports, and letters.
- Experience in the use of computer software, specifically Windows, Microsoft Outlook, Word, and Excel.
- Ability to organize workload, set priorities and meet deadlines.
- Experience working in a pharmacy or health care setting where drug knowledge was requires.
In compliance with the Americans with Disabilities Act (ADA), HHS agencies will provide reasonable accommodation during the hiring and selection process for qualified individuals with a disability. If you need assistance completing the on-line application, contact the HHS Employee Service Center at 1-888-894-4747. If you are contacted for an interview and need accommodation to participate in the interview process, please notify the person scheduling the interview.