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 Legal & Compliance department ensures our business operations and processes are compliant with all state and federal requirements. They keep Abarca updated on all regulatory and legislative developments to mitigate impact on the services we offer! They're also the team we go to for channeling services from our external legal counsel and working on matters related to tax, audits, managing codes of conduct as well as corporate, and healthcare law.

As our Senior Compliance Auditor, you will be responsible for ensuring successful completion of assigned audit engagements set forth in the company’s Audit Plan with the delegated entities. You will manage and carry out operational audit activities as assigned. You will also be responsible for any external audits including Abarca’s delegated entities. In this position you are also responsible for applying audit & monitoring techniques to examine documentation, interview employees, and conduct analysis of data to identify deficiencies and best practices in controls and compliance with the Center for Medicare and Medicaid Services (“CMS”) requirements as well as any other relevant agency and organizational policies and procedures. As our Senior Compliance Auditor, you need to be knowledgeable about the regulatory requirements that apply to the areas subject to auditing and monitoring activities as conducted under the compliance program.

The fundamentals for the job…

• Identifying and managing potential risks associated with delegation of services, such as data breaches, compliance violations, or operational disruptions.
• Manage the execution and documentation of all auditing and monitoring activities, according to the established annual work plan.
• Ensure processes are followed in accordance with policies and procedures and regulatory guidance.
• Perform analysis and trending compliance audits. Continuously evaluate specific audit/monitoring activities and determine if more formal or in-depth interventions are required.
• Prepare clear and concise reports with the evaluations of risk, root cause, and scope of impact of the internal audit findings.
• Performance Monitoring- tracking and evaluating the performance of delegated entities through regular reporting, audits, and reviews to ensure accountability and transparency.
• Develop and implement audit tools based on regulatory protocols and guidance.
• Work with areas to identify root cause and ensure any findings are corrected promptly and documented properly.
• Perform follow-up monitoring as required to assess improvement on findings and ensure effectiveness of corrective actions resulting from previous audit/monitoring activities as well as issue management process.
• Act as liaison between Clients and the Company for the coordination of external audits, facilitating a responsive and responsible audit process, including corrective actions, if applicable.
• Keep up to date with regulatory requirements and best practices.
• Create or review any policies and procedures or training, as needed.
• Establish and manage communication and escalation methods.
• Serve as liaison between Compliance and Abarca business units relating to all audits performed by client or regulatory agencies.
• Coordinate with areas for reporting requirements or audit universe submissions, including gathering reports, performing quality assurance validations and final submission to clients.
• Other Compliance, audit, or reporting requirements activities as needed.

What we expect of you

The bold requirements…

• Bachelor’s or Master’s degree in Health Services Administration, Public Health, Health Evaluation, Health Economics, Statistics, Science, or a related mathematics field. (In lieu of a degree, equivalent relevant work experience may be considered)
• 6+ years of experience in Medicare Part D Compliance or Audits.
• Experience in PBM Operations.
• Experience executing audits to evaluate compliance with CMS regulations and Part D requirements, including but not limited to coverage determinations, appeals, credentialing, PDE submissions, and formulary management.
• Demonstrated ability to work in collaboration with internal and external stakeholders.
• Strong problem-solving and negotiation skills within a regulatory context.
• Excellent oral and written communication skills.
• We are proud to offer a flexible hybrid work model, which will require certain on-site workdays (Puerto Rico location only).

Nice to haves…

• Certified in Healthcare Compliance (CHC), and/or Certified Fraud Examiner (CFE), and/or Certified Internal Auditor (CIA).

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. 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.

#LI-REMOTE #LI-JM1

LI-HYBRID #LI-JM1

Whatyou’lldo  

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… 

Asan AssociateFormularyAnalyst,youwillberesponsibleforconfiguring and implementing formularies across Medicare, Commercial, and Employer clients, including complex setups and process changes. 

The fundamentals for the job… 

• Execute standard formulary setups for new Medicare, Commercial and Employer client implementations, and process changes for existing clients.
• Perform unit testing to confirm configuration set-up or changes are processing as expected as defined in the client documentation.
• Conduct design review of peers on the proposed build design and configuration peer review.
• Perform Quality Control and Quality Assurance functions to assess information accuracy in all Formulary Management processes.
• Support the research and resolution of adjudication and processing issues including, identification of root cause, impact analysis determination and corrective action.
• Apply appropriate senseof urgency support to other areas to verify and analyze claims processing cases, eligibility, and other operational situations and issues referred for validation within SLAs/SLOs.
• Collaborate and coordinate with other business units to execute configuration as required.
• Responsible for daily tracking and monitoring of assigned requests to ensure due dates are met.
• Basic understanding of external regulator guidelines such as Medicare, Medicaid, and state requirements, to make timely adjustments to operations ensuring our processes follow compliance, rules, and regulations.  
• Provide feedback on processes and make recommendations for improvements.
• Support analysts in creating new knowledge articles related to formulary topics. 

 What we expect of you 

The bold requirements… 

• Associate orBachelor’sdegree in a related field(In lieu of a degree, equivalent, relevant work experience may be considered.).
• 1+ years ofexperience in a healthcare non-retail pharmacy setting within asimilar or related role. 
• Pharmacy Technician accreditationas well as a current and activelicense. 
• Experience with areas of clinical expertise. 
• Experience applying customer service and presentation skillswithin clinical operations. 
• Excellent oral and written communication skills. Bilingual fluency in Spanish and English isrequired. 
• We are proud to offer a flexible hybrid work model which will require certain on-site work days(Puerto Rico Location Only). 
• This position requires availability to work in a specified time zone or working schedule, accommodating the business needs of our clients and team members.
• This position may require availability for on-call hours, including evenings, weekends, and holidays, to promptly address emergent issues or provide necessary support as dictated by operational demands (if applicable). 

Nice to haves…  

• Experience or coursework in expanded benefitsand/orinsurance industry.  
• Experience withPBM clinical operations and Medicare Part Dregulations.  

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 andparticipatesin E-Verify.  “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’ssimply meant to give readers an idea of what the role entails. 

#LI-REMOTE #LI-JM1

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…                          

As the Director of Configuration Operations, you will oversee the pharmacy operations team, ensuring that consultative and quality-focused configuration solutions are delivered to clients promptly. Your team serves as the face of Abarca configurations, and your role is to lead them in adhering to quality processes that meet our clients' needs. This position encompasses managing all aspects of successful configuration, including the creation of components, following system design standards, and executing testing methods to guarantee quality and consistency. You will address issues within the team and across departments to achieve desired outcomes and may also involve reviewing and negotiating tactical and strategic solution options to ensure client satisfaction.  You will engage with various departments and roles within the company as well as a dynamic combination of external clients and stakeholders.  Hence your messaging, executive presence and situational awareness are critical.  Applying various influencing techniques to gain alignment will be a part of your day-to-day execution skills.

The fundamentals for the job…

• Leadership and Team Management: Oversee configuration operations teams, providing strategic direction, mentorship, and professional development to ensure high performance.
• Strategic Client Relationship Management: Establish and maintain strong, long-term relationships with key clients at an executive level, serving as the primary escalation point for complex issues.
• Strategic Planning and Data Analysis: Conduct high-level data analysis to identify trends and opportunities, developing and presenting strategic recommendations to clients.
• Client Communication and Reporting: Lead the development of communication strategies to convey configuration options and recommendations, ensuring clear and impactful client reports and presentations.
• Collaboration and Cross-Functional Coordination: Collaborate with internal departments to ensure seamless configuration and service delivery, enhancing interdepartmental communication and collaboration.
• Gap Analysis and Solution Design: Conduct advanced gap analysis to evaluate complex client requirements, providing high-level insights and recommendations for solution design.
• Training and Mentorship: Lead training programs for clients and internal teams on advanced configuration tools and processes, mentoring Senior Configuration Architects and other team members.
• Post-Implementation Support: Oversee post-implementation activities, resolving advanced configuration issues and ensuring client satisfaction.
• Continuous Improvement and Innovation: Propose and lead enhancements to improve configuration efficiency and effectiveness, driving initiatives for continuous process improvement and innovation.
• User Acceptance Testing (UAT): Lead and participate in UAT testing for advanced product enhancements, ensuring thorough testing and validation of configurations to meet client requirements. Ensure thorough testing and validation of configurations to meet client requirements.
• Monitoring overall performance and managing the development of the Configuration Operations teams, including setting, reviewing, and measuring quality standards, documentation standards, processes, and procedures.
• Conduct performance reviews, quarterly/semiannual check-ins, and staff meetings to guide performance management and employee development efforts and direct them toward departmental goals, including quality and process improvement efforts.

What we expect of you  

The bold requirements…    

• Bachelor’s Degree or Master’s Degree in Engineering, Business or Health Administration. (In lieu of a degree, equivalent relevant work experience may be considered.)
• 10+ years of experience within a role in pharmacy benefit management and external regulator guidelines (such as Medicare, Medicaid, and state requirements).
• Experience within a leadership role overseeing teams and developing them.
• Ability to prioritize and handle multiple projects at once without missing deadlines.
• Excellent oral and written communication skills.
• Excellent analytical and problem-solving skills.
• We are proud to offer a flexible hybrid work model which will require certain on-site workdays (Puerto Rico Location Only)
• This position requires availability to work in a specified time zone or working schedule, accommodating the business needs of our clients and team members.
• This position may require availability for on-call hours, including evenings, weekends, and holidays, to promptly address emergent issues or provide necessary support as dictated by operational demands (if applicable).

Nice to have…

• Experience working with Azure and SQL.
• Pharmacy Technician accreditation.
• Project Management Certification/Experiences

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.  “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.

#LI-NO1 #LI-REMOTE

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…

Our Data Exchange team handles all incoming and outgoing data with scrutiny and security in mind. As Manager of Data Exchange Support, you will lead our efforts in improving and maintaining a robust 24/7 support model for our B2B data exchange services, ensuring high availability, reliability, and exceptional customer experience.

The fundamentals for the job…

• Establish and maintain KPIs for data exchange operations, focusing on client satisfaction, response time, and resolution efficiency.
• Enhance observability and monitoring through automation, implementing tools and techniques to proactively identify and address issues.
• Establish proper managerial routines to address issues in a timely manner, ensuring swift resolution and minimizing impact on operations.
• Develop and implement team Service Level Objectives (SLOs), creating comprehensive dashboards to track performance and guide decision-making.
• Lead and institutionalize a robust Root Cause Analysis process for all major incidents and recurring issues. Translate RCA findings into actionable improvement plans and preventive measures.
• Collaborate with business data management teams, engineering, and clients to ensure seamless data exchange and support processes.
• Manage and prioritize multiple projects and support tickets, ensuring adherence to service level agreements (SLAs).
• Manage, coach, and develop a team of data support specialists.
• Lead the transition to support 24/7 operations, collaborating with the Network Operations Center (NOC) to optimize processes.
• Partner with engineering teams on optimizing data pipelines to ensure data quality, consistency, and accessibility across the organization.
• Partner with engineering teams on initiatives to address technical debt and improve testing processes.
• Create and maintain comprehensive documentation for relevant support procedures.
• Oversee disaster recovery and business continuity planning for data systems.

What we expect of you

The bold requirements…

• Bachelor's Degree or Master's Degree in Computer Engineering, Computer Science, or related field. (In lieu of a degree, equivalent relevant experience may be considered.)
• 8+ years of experience in data engineering operational role. 
• 2+ years of experience in a managerial role.
• Excellent leadership, problem-solving, and decision-making skills.
• Outstanding collaboration, communication, and interpersonal skills.
• Proven ability to establish and maintain operational routines and drive continuous improvement.
• Experience in managing and reducing incidents and recurrent issues in data operations.
• Familiarity with cloud platforms (AWS, GCP, or Azure) for data engineering.
• Strong customer service orientation with a track record of building relationships with internal and external stakeholders.
• Proficiency in implementing and managing observability and monitoring solutions for complex data systems.
• Experience in establishing and tracking Service Level Objectives (SLOs) and creating performance dashboards.
• Excellent oral and written communication skills.
• We are proud to offer a flexible hybrid work model which will require certain on-site workdays (Puerto Rico Location Only)
• This position requires availability to work in a specified time zone or working schedule, accommodating the business needs of our clients and team members.
• This position may require availability for on-call hours, including evenings, weekends, and holidays, to promptly address emergent issues or provide necessary support as dictated by operational demands (if applicable).

Nice to haves…

• Certifications in process excellence methodologies (e.g., Six Sigma, Lean) or ITIL.
• Familiarity with HIPAA regulations.
• Experience in ETL design and implementation.
• Advanced knowledge of automation tools and techniques for data engineering and support processes.
• Experience with healthcare utilization reporting, claims, membership, provider data, and standard Healthcare metrics.

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.  “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.

#LI-REMOTE #LI-BM1

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 Data Architect is responsible for designing, implementing, and overseeing an enterprise-wide data architecture that aligns with the organization's data strategy and goals. This role involves collaborating with internal teams, stakeholders, and leadership to manage data solutions across multiple platforms and ensure data quality, integrity, and security. The Data Architect will lead efforts to implement data-driven solutions, streamline data management processes, and support the organization in evolving its data architecture, including future initiatives like data mesh, data fabric, and graph databases.

The fundamentals for the job…

• Coordinate with internal teams to support clients, data users, and key stakeholders to develop and achieve long-term objectives for data architecture.
• Design short-term solutions to achieve project goals and create a data roadmap for management.
• Determine procedures for identifying and collecting required data, validating processes, and recommending improvements to corporate data.
• Oversee and monitor frameworks that manage data across the organization, ensuring data quality and integrity.
• Support the Product and Data Management Team in applying methodologies that adhere to required data standards.
• Administer mapping of all data sources and data movement, analyzing them to ensure appropriate quality. 
• Collaborate with project supervisors and business leaders to manage enterprise data projects.
• Manage data-related problems such as system configuration and integration on multiple platforms.
• Provide training to staff on data management, improving operational efficiency.
• Develop key metrics for data quality tests, ensuring data architecture integrity.
• Prepare and maintain documentation for data architecture, ensuring knowledge on large data structures.
• Analyze information flow and recommend appropriate technologies to support business processes.

What we expect of you 

The bold requirements…

• Bachelor’s Degree or Master’s Degree in Engineering, Business or a related area (In lieu of a degree, equivalent, relevant work experience may be considered.)
• 8+ years of experience implementing large-scale data solutions, particularly in healthcare and pharmacy data domains.
• Deep knowledge and experience with data architecture, management strategies, including data profiling, cleansing, and conversion.
• Strong leadership and stakeholder engagement skills with excellent oral communication, presentation, and problem-solving abilities.
• Experience in communicating complex data architecture designs effectively to both technical and non-technical audiences.
• Proven track record of designing, implementing, and managing data architectures in large environments interfacing multiple subsystems.
• Experience collaborating with architects and leads, serving as the data SME across architectural contexts.
• Expertise in providing technical advice on data management, governance, and enterprise data integration strategies.
• Demonstrated experience in data migration, transformation, and deployment in collaboration with DBAs, development, security, and operations teams.
• Experience developing SLAs and data governance standards to ensure data integrity, retention, and compliance.
• Familiarity with emerging data strategies and technologies like data mesh, data fabric, and graph databases.
• Proven ability to manage data across technologies such as Microsoft SQL Server, Azure SQL, CosmosDB, PostgreSQL, Redis, Solr, and Azure Service Bus for streaming.
• Drive the design and implementation of a data-driven strategy across all components of Darwin, fostering the concept of data products per domain.
• Excellent oral and written communication skills.
• This position requires availability to work in a specified time zone or working schedule, accommodating the business needs of our clients and team members.
• This position may require availability for on-call hours, including evenings, weekends, and holidays, to promptly address emergent issues or provide necessary support as dictated by operational demands (if applicable).

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.  “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.

Whatyou’lldo  

 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… 

 As the Business Support Analyst, you will provide 2nd level support to our internal and external platform users. You will perform root cause analysis of issues and help determine and implement solutions. Also, answer and triage incoming requests and issues to aid and complete details to the operations and technical staff as needed. You will be a Product Subject Matter expert in a particular domain that will allow you to conduct more in-depth analysis and troubleshooting. Further, this role acts as a liaison between different departments in a company and their customers. You specialize in the Darwin domain, working to ensure everything functions as intended or addressing user issues that do arise. 

 The fundamentals for the job… 

• Serveas a Darwin product support domain expert analyst and escalation point for platform support related services and incidents. 

• Collaboratewith business users and technical teams to gather information, understand, define impact, research, analyze, and resolve issues and/or platform problems.  

• Align with technical teams on suitable technical, application, or configuration solutions to incoming incidents and issues. 

• Maintain frequent communication with peers and IT teams to maintain awareness of issues or changing processes. 

• Understand the business implications of technical solutions andassistin defining and documentingtechnological solutions.  

• Escalates and collaboratesonmajorincidents and issues with teams in: Technical Areas, Issue Management, Client Services, Operations, among others.  

• After operations teams’avenues are exhausted, respond to questions/inquiries from platform users on functionalities or configuration processes. 

• Ensure ticket and work item documentationremainscurrent, correct, and relevant including updates to users on status,user-provided input,investigation results, next steps,and estimated delivery time (ETAs) forresolutions. 

• Maintain high operational and written standards throughout ticket documentation and management.  

• Coordinate andat times lead meetings when needed for issue resolution. 

• Identifyrepetitive open known issues for their centralization in a single work item, serve as internal escalation and triage point for first level BSAs andassistteams in troubleshooting issues.  

• Participate in continuing education, committee, and meetings as may be requested or required by their immediate supervisor. 

• Develop into aDarwin Product Support domain expert in a particular domain and work closely with that cell to be able to conduct in-depthreview, analysis and debugging of the issue. 

• Assist Business Support and Scrum Team in prioritizing development/product work items within their domain area and clarifying issues and its resolutions. 

• Create Run Books, knowledge articles and incident management documentation for Business Support BSA 1st level and 2nd level troubleshooting of issues, per their SME area of expertise, as well as other documentation as needed. 

• Provide guidance and back up support to other team members andbe responsible forthe monitoring and at times the distribution of tasks among them, asdesignatedby Team Lead and/or Manager. 

• Serve asdomainexpertfor specific areasin client calls if needed. 

• Assist Team Leader and/or Manager in training new hires and team members.On occasion, focusing onparticular domainexpertise to transfer such knowledge and train new 2nd level members if needed. 

• Performadditionalduties as needed. 

 What we expect of you: 

The bold requirements…  

• Bachelor’s DegreeorMaster’s Degreein a related area. (In lieu of a degree, equivalent relevant experience may be considered.)  

• 3+years of experience ina role relating to business analysis, business support, operational support, or software engineering.  

• Experience with Microsoft Office Products such asPowerBI, Excel, PowerPoint, andWordDoc.  

• Experience using customer service skills to deliver quality and satisfactory service to internal and external clients using tech platforms.  

• Experience in using analytical skills and root cause analysisregardingtechnological solutions, issues,incidents,and problems.  

• Experience applying intermediate SQL skills to related areas in software support, technicaltroubleshootingand dataanalysis..Abilityto work rotating or irregular shifts, including weekends and certain holidays, per business or operational needs. 

• Must be willing to travel (5% of time) per year (out of state to the island). 

• Excellent oral and written communication skills. 

• We are proud to offer a flexible hybrid work model which will require certain on-site workdays (Puerto Rico Location Only)  

• This position requires availability to work in a specified time zone or working schedule, accommodating the business needs of our clients and team members. 

• This position may require availability for on-call hours, including evenings, weekends, and holidays, to promptly address emergent issues or provide necessary support as dictated by operational demands (if applicable). 

 Nice to have…  

• Experience withthe Pharmacy and Pharmacy Benefit Management industries, Medicare Part D, and CMS regulations 

• Experience with Product Support and/or Product Knowledge.  

• Experience with software and support areas such as ticketing systems, customer relationships management (CRM) tools,software development life cyclesand Azure DevOps platform. 

 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 andparticipatesin E-Verify.  “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’ssimply meant to give readers an idea of what the role entails. 

#LI-REMOTE #LI-JD1

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…

Making healthcare awesome is key to everything we do at Abarca, and so the Strategy to Execution team helps us reach those heights through service design, project and process improvement, and strategy planning! From Project and Process Improvement to Innovation and Business Enabling to Strategic Management, this team tackles existing and innovative programs or processes at Abarca to rethink, reshape and rework how we do what we do.

As our Business Partner, Project Management, you will manage multiple medium-sized projects or 1-3 highly complex and large-sized projects. You will have overall accountability for each assigned project and be responsible for project conception through completion, including scope, time, and budget, following our Project Management and Process Improvement methodology. You’ll be expected to document status, agreements and learnings from all meetings and presentations, and lead overall coordination, status reporting and stability of project work efforts.

The fundamentals for the job…

• In this role, you’ll be responsible for managing multiple medium-sized projects or 1-3 highly complex large-sized projects.
• You are to oversee overall coordination, status reporting and stability of project work efforts.
• You’ll establish and implement management processes and methodologies to ensure projects are delivered on time, within budget, adhere to high quality standards and meet expectations.
• You get to define the scope, develop plans, manage milestones, develop, and carry out appropriate communication plans with stakeholders; you also develop relationships with cross functional partners and align project timelines to ensure they are completed meeting stakeholder needs.
• Assemble project plans and teamwork assignments, direct and monitor work on a daily basis, identify resources needed, perform quality reviews, and escalate functional, quality, and timeline issues appropriately.
• Keep track of key milestones and adjust plans and/or resources to meet customer needs.
• Schedule and monitor project deliverables.
• Coordinate communication with all areas that impact the scope, budget, risk, and resources of the project.
• Manage and update project plan using Microsoft Project tool and keep team informed of status and deliverables.
• Provide weekly/monthly/quarterly progress reports to management, as needed.
• Provide oversight and leadership in executing projects from planning to completion to provide results to the business​.
• Assess, prioritize, and provide a health check report of active projects.
• Provide advice to optimize business performance and assist in the development of the department’s strategy​.
• Provide operational process improvements, identifying, analyzing & improving current business processes to optimize performance, meet best practices & improve quality.
• Work in tandem with other teams to automate processes, improve functionality, identify inefficiencies and areas for improvement, and drive advances that impact both, the team’s performance as well as the client expecting deliverables.
• Provide education, training and presentation of project updates, new processes, and tools for users.
• Be generally amazing and awesome to the point that people want to work projects of which you are in charge.
• Perform any other tasks or special projects as assigned.

What you’re made of

The bold requirements…

• Bachelor or Master’s Degree Engineering, Business or Economics (In lieu of a degree, equivalent relevant experience may be considered.)
• 3+ years of experience in consulting, engineering, and project management teams.
• Experience with data analytics tools (e.g. Excel, Tableau, PoweBI)
• Experience leading cross-functional initiatives, driving performance, and executing on deliverables while leveraging tools and techniques.
• Experience in leveraging excellent communication to achieve commitment from stakeholders, good organizational skills for projects and problem-solving experience when issues arise.
• Excellent oral and written communication skills, bilingual fluency in Spanish and English is required.
• We are proud to offer a flexible hybrid work model which will require certain on-site workdays (Puerto Rico Location Only)

Nice to haves…

• PMI Credential (PMP, PgMP, PMI-ACP, PMI-SP, or PMI-RMP).
• Experience with Microsoft Projects Server.
• Experience in health insurance or PBM setting managing projects.

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.  “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.

#LI-MH1 #LI-REMOTE

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…

As our Regulatory Compliance Analyst, you will be responsible for ensuring that business operations and procedures are compliant with all state and federal regulatory requirements and abide by State Medicaid Plans as applicable to Abarca. You will ensure that business owners receive, understand, and abide by all federal and state regulations. You will be an independent and critical thinker, and an effective communicator. It is important that you are always up to speed on all regulations applicable to Abarca operations and delegated services.

In this position you will support the Regulatory Compliance Team, in executing Abarca’s Regulatory Change Management Process, including regulatory trainings, Policies & Procedures management, and regulatory consults. You will perform a range of duties such as evaluating compliance regulations and guidance, supporting operational areas in the implementation and documentation of new requirements, and researching and responding to regulatory consults. You will also be responsible for acting as a consultative figure to our clients on regulatory topics, addressing possible changes to delegated services and regulatory questions stemming from potential audit concerns. 

The fundamentals for the job…

• Stay abreast of all regulatory requirements and legislation, industry trends, and best practices.
• Keep track of regulatory changes for Commercial, Medicare and/or Medicaid, as assigned, including State Medicaid requirements for those states in which Abarca processes claims.
• Monitor regulatory changes and assess any potential impact of these changes in Abarca’s processes.
• Work with business areas to discuss identified changes in regulation, define required actions, and ensure requirements are implemented as appropriate.
• Participate in the Regulatory Change Management (RCM) Committee meetings, presenting regulatory updates and engaging participation of subject matter experts (SME’s).
• Prepare Compliance Updates and summaries of regulatory requirements identifying required actions, for internal and external stakeholders and maintaining updated Abarca’s regulatory log.
• Work with operational areas to ensure that required actions derived from guidance are completed, including implementation of new processes, updating current processes, and advising on compliant operations, in accordance with applicable due dates.
• Lead Policies and Procedures Management process, creating or reviewing P&P’s and ensuring that P&P’s are reviewed within required frequency, and updated with federal and state regulatory requirements, current operations, and overall business operations.
• Develop a user-friendly system for maintaining the organization’s policies and procedures and ensure they are properly published to the entire organization.
• Implement regular communication methods to keep all employees informed of policy and procedure updates.
• Perform research and review guidance to provide timely responses to regulatory questions from clients and business areas.
• Support the Regulatory Compliance Audits team with regulatory requirements and documentation.
• Support in the development/update of regulatory compliance training materials. Ensure all Abarcans and delegated entities receive new hire and annual regulatory trainings. Develop ad-hoc trainings of regulatory topics as needed.
• Support HIPAA investigations, specifically review and keep track of applicable federal and state requirements, including State Medicaid requirements and Client Business Associate Agreements. Act as liaison with the Security Team when system security issues are involved.
• Maintain and report results on Compliance metrics and assigned Service Level Agreements.

What we expect of you

The bold requirements…

• Bachelor, Law Degree, or Master’s Degree in Health Services Administration, Public Health, Health Evaluation or related field (In lieu of a degree, equivalent, relevant work experience may be considered.)
• 3+ years experience in Healthcare Compliance and/or regulatory management role.
• Computer proficiency, knowledge of Microsoft Office products, and Internet experience.
• Strong understanding of industry processes, healthcare regulations, and PBM Operations.
• Excellent oral and written communication skills. 
• We are proud to offer a flexible hybrid work model which will require certain on-site work days (Puerto Rico Location Only).
• This position requires availability to work in a specified time zone or working schedule, accommodating the business needs of our clients and team members.
• This position may require availability for on-call hours, including evenings, weekends, and holidays, to promptly address emergent issues or provide necessary support as dictated by operational demands (if applicable).

Nice to haves…

• Preferred Certification in Healthcare Compliance (CHC), and/or Certified Fraud Examiner (CFE), and/or Certified Internal Auditor (CIA).

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.  “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.

#LI-REMOTE #LI-JM1

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…

Providing high-quality services to clients and beneficiaries is at the core of what we do every day! The PBM Operations & Services team is the very heart of Abarca and meets that standard by running services from MTM, price eligibility, configurations, and beneficiary services to government services and beyond. Rx Customer Service leads the front lines in conducting satisfaction surveys, addressing complaints, managing manual reversal requests, and other needs for our beneficiaries, pharmacies, and clients.

As the Associate Rx Customer Service Specialist, you will serve at the front line of all incoming and outgoing communication (calls, emails, and faxes) with pharmacies, beneficiaries, and prescribers. You will use the Rx Platform and other resources as necessary to resolve the caller’s needs.

The fundamentals for the job…

• Manage all incoming calls, emails, faxes and web-generated requests from pharmacies, beneficiaries, and prescribers.
• Provide service-level standards set by CMS or by client; 80% of calls should fall within service level, less than 5% abandon rate and speed to answer should be less than 30 seconds.
• Rejection support, including overrides.
• Provide Coverage Determination status to clients including exceptions and appeals.
• Administrative PAs- Document PA request inquiries, issues, status, and resolution in accordance with federal and department and company policies and guidelines.
• Answer questions and recommend corrective services to address customer complaints, payment status, manual reversal requests, benefit and eligibility support, provider portal support and response to price appeals.
• Report identified issues to the appropriate department, for investigation and correction, following the established procedure.

What we expect of you

The bold requirements…

• Associate’s Degree in Pharmacy Technician (in lieu of a degree, equivalent, relevant work experience may be considered).
• 1+ years of experience working in a Pharmacy or Member Services Call Center, Retail or Hospital Pharmacy Setting.
• Excellent oral and written communication skills. Bilingual fluency in Spanish and English is required.
• We are proud to offer a flexible hybrid work model which will require certain on-site workdays (Puerto Rico Location Only).
• This position requires availability to work in a specified time zone, accommodating the business needs of our clients and team members based in the in the determined time zone.
• This position may require availability for on-call hours, including evenings, weekends, and holidays, to promptly address emergent issues or provide necessary support as dictated by operational demands (if applicable).

Nice to haves…

• Active Pharmacy Technician License is preferred.
• Experience in PBM, Medicare Part D, Commercial/Employer Plans, Insurance, Pharmacy, and / or healthcare.

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. 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.

#LI-REMOTE #LI-TA1

Whatyou’lldo  

Inafew 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 Legal & Compliance department ensures our business operations and processes are compliant with all state and federal requirements. They keep Abarca updated on all regulatory and legislative developments to mitigate the impact on the services we offer! Within this team, the Pharmacy Integrity group handles FWA and related regulations to ensure we're maintaining standards and compliance in all pharmacy related processes, claims and transactions. 

As our Pharmacy Integrity Specialist, you will be responsible for performing audits of pharmacies within the Company’s Provider network, as detailed in the Company’s Network Agreements. Audits are a fundamental part of maintaining a first-class and comprehensive network and must be completed with great attention to detail to prevent, identify and control potential cases of Fraud, Waste and Abuse (FWA), as defined by CMS. Additionally, as a Pharmacy Audits Specialist you must maintain excellent relations with members of the Provider Network and internal partners. 

The fundamentals for the job… 

• Complete in-person andlong-distanceaudits of pharmacies within the Company’s Provider Network, paying special attention to conforming to all Company, Client, and CMS policies and proceduresincludingprescriptions, documentation,and credentialing.  
• Collectvirtual andphysical evidence of claimsas well ascarry out pharmacy onsite audits. 
• Investigate paid claims toidentify errors, track patternsforpossible casesof FWA.  
• Prepare quarterly reports on audit processes and timelines, detailing recent findings,determiningoverpaymentsas well as submit findings adequately.  
• Analyze FWA referrals from clients, other departments,members,and hotline calls.   
• Reviewand promptly respond to requests for information from law enforcement agencies and plan sponsors (clients).  
• Analyze audit findings todeterminevalidity of any identified discrepancieswhile bearingthe full responsibilityof identified issues during audits.  
• Write the final audit discrepancies notification letter and audit report for pharmacies.  

What we expect of you

The bold requirements…  

• Pharmacy Technician Associate Degree (In lieu of a degree, equivalent relevant work experience may be considered.) 
• 3+ years of experience in a related role. 
• Experienceworking withfraud, waste and abuse regulationsand industry trends. 
• Experience in handlingfull analysis, from issue identification up to providing reports. 
• Excellent oral and written communication skills.Bilingual fluency in English and Spanish is required.
• We are proud to offer a flexible hybrid work model which will require certain on-site workdays (Puerto Rico Location Only) 

Nice to haves…  

• Specialty Pharmacy experience is preferred. 
• Experience within the Healthcare, Pharmacy Benefit Management, and Insurance industriesis a plus.  
• Certified Fraud Examiner.  
• Experience related toCMSandMedicare Part Dis preferred.  

Physical requirements… 

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

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’ssimply meant to give readers an idea of what the role entails. 

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

All qualified applicants will receive consideration for employment and will not be discriminated against on the basis of gender, race/ethnicity, gender identity, sexual orientation, protected veteran status, disability, or other protected group status.

#LI-NO1 #LI-REMOTE

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 Darwin Claims Administration team provides high quality services to clients and beneficiaries and meets that standard by configuring timely and accurate updates related to plan benefit, pricing, and network changes and beyond. The Darwin Claims Administration team handles all claims verifications, daily configuration set-up and maintenance, and related special projects, issue management and research for benefit configuration.

As a Darwin Claims Analyst, you will be responsible for implementing new and updating existing benefit plan setups for Medicare, Medicaid, Commercial and Employer clients. Also, you will review client configuration requests, identify, and define their needs and requirements, determine the best operational approach, and perform setup in the Pharmacy Benefit Manager system. The position also requires that you perform client configuration setup testing on all plan benefit design changes into a production scenario to ensure proper and accurate configuration for claims processing and adjudication. Additionally, you will provide first level triage for operational issues, analyze, and identify solutions to resolve issues in configuration setup, claims processing and other operational gaps.

The fundamentals for the job…

• Pharmacy Benefit Manager System Configuration setup and maintenance for pharmacy benefits, networks and pricing for Medicare, Medicaid, Commercial and Employer groups.
• Perform testing to confirm configuration set-up or changes are processing as expected as defined in the client documentation.
• Develop in-depth understanding of Darwin (proprietary adjudication platform) system logics to ensure benefit designs are configured to meet client request.
• Provide timely first-tier triage support to verify and analyze pharmacy claims processing case research referred for validation.
• Support pharmacy claims adjudication research, analysis, identification of root cause, impact analysis determination and corrective action.
• Responsible for daily tracking and monitoring of assigned requests to ensure due dates are met.
• Utilize critical thinking and organizational skills to ensure all work is performed with the highest level of quality, accuracy and delivered timely.

 What we expect of you

The bold requirements…

• Associate or bachelor’s degree. (In lieu of a degree, equivalent relevant work experience may be considered.)
• 3+ years of work-related experience.
• Experience working with SQL and Excel tools.
• Ability to establish good interpersonal skills.
• Excellent oral and written communication skills.
• We are proud to offer a flexible hybrid work model which will require certain on-site work days (Puerto Rico Location Only).

Nice to haves…

• Experience in a healthcare non-retail pharmacy setting.
• Experience related to Pharmacy Benefit Manager Operations, Member Services, Pharmacy Networks, Fulfillment, Call Center, and Medicare.

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.

 #LI-NS1 #LI-REMOTE

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 Cloud Infrastructure Engineering Team manages and maintains all cloud-related systems, network, and infrastructure at Abarca Health. Our team ensures peak performance, availability, stability and security of our cloud-based systems and platform. We leverage the latest Azure technologies to continually improve and modernize our cloud operating environment. We partner with product and software development teams to drive business outcomes.

Azure Cloud Engineers -FinOps are responsible for the maintenance of secure and highly available cloud computing environments. This position is designed for someone who is passionate about leveraging cloud technologies to optimize financial operations within Azure environments. You will be instrumental in driving cost-efficiency and maximizing cloud investment returns.

The fundamentals for the job…

• Implement and manage Azure cloud services focusing on cost optimization and financial governance.
• Collaborate with IT and finance departments to develop and enforce cloud spend policies and best practices.
• Analyze and report on cloud expenditures, providing insights and recommendations for cost savings and operational efficiencies.
• Use Azure Cost Management tools to monitor, allocate, and optimize expenditures across multiple departments and projects.
• Develop automated solutions for budget tracking, alerting, and reporting to enhance visibility and control over cloud costs.
• Design and implement tagging strategies to ensure accurate cost allocation and chargebacks.
• Lead cloud cost reduction initiatives, including reserved instances, sizing, and scaling adjustments.
• Stay updated with Azure’s pricing and service catalog to advise on cost-effective cloud architectures and services.
• Train and mentor team members on Azure cost management practices and tools.
• Collaborate with architecture and engineering teams to ensure cost-efficiency is embedded in all cloud projects.

What we expect of you

The bold requirements… 

• Bachelor’s degree in Computer Science, Information Technology, Finance, or a related field.
• 3+ years of experience in cloud engineering with a strong emphasis on Microsoft Azure environments.
• Deep understanding of Azure services, pricing models, and billing dashboard.
• Proven experience with Azure Cost Management, Budgets, and other financial management tools.
• Strong analytical skills and the ability to interpret financial data to make business recommendations.
• Experience with scripting languages (PowerShell, Python, etc.) for automation of cloud services.
• Excellent communication and collaboration skills to work effectively across teams.

Nice to haves…

• Certifications in Azure, such as Azure Cost Management and Billing preferred.
• Financial experience, cost accounting/billing experience.

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.

#LI-REMOTE #LI-MH1

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…

Our IT Service Operations team is critical for success at Abarca Health. You will handle day to day systems operations and monitoring of data processing to server updates, review stability and collaborate to ensure the stability of networks and datacenters.

As the Monitoring and Tools Analyst, you will be part of our IT Service Operations team, and will be responsible for building, maintaining, and supporting the monitoring tools used to detect, mitigate, and resolve application and infrastructure issues. This includes setting-up, maintaining, and continuously improving Abarca’s various monitoring, visualizations, alerting and notification tools, enabling other teams to respond to incidents, as well as providing recommendations for areas of opportunity.

The fundamentals for the job…

• Install, configure, and maintain the tools used by the organization for monitoring, alerting, notifying, and diagnosing issues.
• Configure and continuously improve the instrumentation of our infrastructure and applications.
• Collaborate with the software engineering teams to better instrument and monitor application features before they are released.
• Monitor vendor information to ensure tools are updated, secured, and optimally implemented as they change.
• Work with the IT Service Operations teams and organizational leaders to produce meaningful visualizations of the monitoring metrics.
• Provide regular updates and reports associated with SLA adherence.
• Create, update, and maintain the documentation of current and new tools.

What we expect of you

The bold requirements…

• Bachelor’s degree or Master’s Degree in Computer Engineering, Computer Science, Information Technology, or related field (In lieu of a degree, equivalent relevant experience may be considered.)
• 3+ years of experience within an IT Operations Support team maintaining the surveillance and monitoring tools or related roles.
• Experience with network infrastructure, network hardware, server operating systems (Windows and Linux), server hardware, server storage, relational databases (MS SQL Server, MySQL, or others) as well as Eventlogs and Syslogs.
• Experience with SNMP and WMI for obtaining metrics and with concepts associated with Web Applications.
• Experience visualizing data.
• Experience with of monitoring tools such as Dynatrace, App Dynamics, Datadog, Splunk, New Relic, Solarwinds, PagerDuty, Evolvenor SCOM.
• Availability to work rotating or irregular shifts, including weekends and certain holidays, per business or operational needs.
• Excellent oral and written communication skills.
• We are proud to offer a flexible hybrid work model which will require certain on-site workdays (Puerto Rico Location Only).

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.

#LI-MH1 #LI-REMOTE

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…

Providing high quality services to clients and beneficiaries is at the core of what we do every day! The PBM Operations & Services team is the very heart of Abarca and meets that standard by running services from MTM to price eligibility to government services and beyond. Our beneficiaries' every concern is satisfied whether it be for a prior authorization, script concern or case management follow up. They're not just an operations team as they also set strategy for new clinical programs based on accurate data. Collaboration is also key as they work with teams like Software Development to design quality processes that meet client requirements, test our systems, and ensure benefits and claims are configured and processed correctly!

As a Medicare Part D Letter Analyst, you will be tasked with conducting investigations and resolving complex issues via strong analytical and communication skills. We’ll rely on you to execute and monitor letter processes for Medicare Part D business including EOBs, Transition, Formulary Negative Change, OIG Exclusion, Provider Preclusion Letters, and more. Grasping new concepts and acquiring platform knowledge through independent study, as well as interaction with other team members, will be essential here. The ability to discuss technical logic, awareness of when to be detailed, and assurance evoked through extensive understanding of our solutions and technology is also a key part of this role!

 The fundamentals for the job…

• Monitor Part D letters and dashboards; identify and initiate error resolution as necessary.
• Analyze pharmacy claims, formulary, provider data, and pricing changes and determine how those affect downstream letters.
• Track, trend, and monitor issues as they arise.
• Understand and reference guidance when analyzing and resolving issues.
• Identify and proactively suggest process improvements.
• Document and explain observations to technical and non-technical audiences.
• Provide guidance and solid understanding of Medicare Part D processes the impact letters.
• Assist in new client implementations and existing client re-implementations to ensure accurate letter logic and content.
• Locate, read, understand, and apply CMS guidance to processes as necessary.
• Understand and execute the quality assurance checks on Medicare Part D processes and communications.
• Review inbound and outbound data files, utilize reports to ensure Medicare Part D process accuracy in various business functions.
• Stay up to date on CMS guidance related to Medicare Part D products.
• Provide client support and/or compliance/audit activities and collaborate in special projects and activities.

What we expect of you

The bold requirements…

• Bachelor’s degree in a related field. (In lieu of a degree, equivalent, relevant work experience may be considered.)
• 3+ years of combined or relevant work-related experience.
• Experience with Medicare Part D processes within a pharmacy benefit manager or health plan.
• Ability to analyze data, reports, and findings to discern patterns and discrepancies.
• Problem solving and analytical skills that are applicable to role processes and procedures.
• Ability to thrive in a high-growth, fast-paced, complex, shifting, and uncertain business environment.
• Highly organized and self-motivated to run and complete important investigations simultaneously.
• Excellent oral and written communication skills.
• We are proud to offer a flexible hybrid work model which will require certain on-site work days (Puerto Rico Location Only). 

Nice to haves…

• Experience with pharmacy paid claim calculations and accumulators is strongly preferred.

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.

#LI-NO1 #LI-REMOTE

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…

Providing high quality services to clients and beneficiaries is at the core of what we do every day! The PBM Operations & Services team is the very heart of Abarca and meets that standard by running services from MTM, price eligibility, configurations, and beneficiary services to government services and beyond.The Darwin Claims Operations team handles all claims verifications, day to day configuration set-up and maintenance as well as related special projects, issue management and research for configuration.

As a PBM Operation Manager, you’ll be responsible for working closely with our Configuration Services Managers to triage configuration tickets for Medicare, Medicaid, Commercial and Employer clients. You will also interpret client configuration requests, defining their request complexity, needs and requirements, to recommend the best operational approach and build repeatable processes. Additionally, you will work hands-on to overview operational issues, analyze and identify solutions to resolve issues in configuration setup, claims processing and other operational gaps, as well as track trends and identify process improvement opportunities to make plan configuration design setup more efficient.

The fundamentals for the job…

• Work with PBM Configuration Services & Operations Leadership to create and drive process for definitions of configuration request type.
• Review configuration ticket queue and triage open tickets to Analysts and Leads strategically and in alignment with client SLA’s and department SLO’s.
• Interpret business requests and determine scope of impact and categorize the complexity of the request to drive accurate SLA assignment.
• Support best practices and recommended approaches to trend solutions.
• Work closely with Configuration Leads and Configuration Architects to determine impact scope and solutions.
• Build, track and monitor department SLA reporting, review and compliance.
• Monitor queues and issue trends to identify opportunities for associate coaching and mentoring.
• Assess error trends and recommend solutions and/or training opportunities to PBM Configuration Services and Operations Leadership.
• Work as a liaison between the business areas within PBM Configuration Services and Operations to ensure alignment, communication and priorities are clear.
• Create a system of early identification of configuration issues.
• Proven ability to demonstrate proactiveness in identifying opportunities for process improvement, problem-solving, and anticipating potential challenges in a dynamic work environment.
• Develop process documentation, including Policies and Procedures, to document Darwin Configuration operational processes.
• Stay current with external regulator guidelines such as Medicare, Medicaid, and state requirements, to make timely adjustments to operations ensuring our processes follow compliance, rules, and regulations.

What we expect of you

The bold requirements…

• Bachelor’s degree in Accounting, Finance, or related field. (In lieu of a degree, equivalent relevant work experience may be considered.)
• Experience utilizing dashboard tools, (e.g., Tableau, QVW, and Excel tools).
• 8+ years of work-related experience.
• 4+ years of PBM and/or configuration experience.
• Ability to apply critical thinking skills to manage responsibilities.
• Extremely detail oriented.
• Excellent oral and written communication skills.
• Proficiency in SQL query writing and execution, with the ability to retrieve, manipulate, and analyze data efficiently.
• Excellent oral and written communication skills.
• We are proud to offer a flexible hybrid work model which will require certain on-site work days (Puerto Rico Location Only).

Nice to haves…

• Experience as a leader of others within the PBM or Healthcare setting.
• Learning and development and/or training experience within healthcare operations, client services, configuration, and/or call center.
• SQL

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.

#LI-NS1 #LI-REMOTE

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…

Our Quality Assurance & Oversight team is key to implementing new clients, testing claims within their respective lines of business and ensuring all claims are paying out correctly. The Quality Assurance team ensures test cases and scripts are developed on the requirements clients has specified and while designing quality review processes with other departments. Along with them, the Product Quality team leverages these skills and functions by focusing on all Abarca related products and software services by collaborating with Product Teams.           

As our Product Quality Analyst you will partner with the Product Team to ensure that business requirements originating from them are developed accurately and configured into our claims adjudication platform, while the Quality Assurance Analysts and Software Testers support the development and testing. You will execute all business functional testing activities to ensure the quality of each client’s pharmacy benefit design and that all new logic integrates with other plans’ programs. As such, understanding those requirements, designing, and defining testing scenarios, executing them and documenting them will be an important aspect of your role. Due to the hands-on level you will take on in this role, the team will support your developing knowledge of both technical and operational sides of the business as you make recommendations on corrective actions and process improvement for testing and monitoring.

The fundamentals for the job…

• Optimize testing and monitoring activities to ensure the quality of the systems and processes supporting the company’s operation.
• Develop into a subject matter expert (SME) on certain lines of business and adjudication logic while stay current with regulatory guidelines.
• Develop, document, and execute test plans, and test cases and scripts based on business functional requirements (independent of Software Test Engineer test plan).
• Analyze, document, and report on test results to business stakeholders and SDLC teams.
• Document and track issues identified during testing activities to ensure defect resolution and testing completion.
• Perform functional testing of the specific adjudication changes being requested, their integration with the specific client rule being tested and related impact to other products. (e.g. member portal, platform visualization).
• Review executed test results with Scrum team, business users, and requestors to ensure acceptance and approval of the results.
• Log all documentation of test plan execution and results in a centralized area available for all SDLC teams.
• Contribute to the business requirement gathering process by identifying missing requirements based on test-cases development and testing experience.
• Collaborate in the development of new ideas and requirements to resolve testing and system’s issues, and improve current systems based on testing results. Collaborate with the Software Test Engineering team to develop and improve testing strategies, techniques, procedures, and tools.
• Participate in product grooming and refinement meetings to gather understanding of new system functionalities and requirements that will require testing and monitoring.
• Team up to support users during issue-solving activities, and day-to-day system operation.

What we expect of you

The bold requirements…

• Bachelor’s degree or Master’s Degree in Business, Engineering, Healthcare, or related field. (In lieu of a degree, equivalent relevant work experience may be considered.)
• 3+ years experience with program testing (claims processing testing), quality assurance practices and tools.
• Experience in pharmacy benefit manager (PBM) setting.
• Experience as a detail-oriented problem-solver, able to quickly spot trends and discrepancies.
• Experience analyzing large data sets while able to use dashboard tools (e.g. Tableau, QVW and Excel tools).
• Experience leveraging strong analytical and critical thinking by being, innovative, accountable and a team worker with a desire to be challenged.
• Experience with Microsoft Office products (e.g. Excel, Power BI).
• Excellent oral and written communication skills.
• We are proud to offer a flexible hybrid work model which will require certain on-site work days (Puerto Rico Location Only). 

Nice to haves…

• Experience with software development life cycle (SDLC), quality assurance (QA) and SQL Management Studios.
• Experience operational standards and processes for healthcare, pharmacy, pharmacy benefit management, Medicare Part D, and Centers for Medicare and Medicaid Services (CMS) regulations.

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.

 #LI-AMBT1 #LI-REMOTE

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…

Our Sales and Business Development gurus are the welcoming heralds for any potential client! They're entrusted with developing the strategy operational relationships that are needed to extend our superior quality, processes, and aid to new beneficiaries. They handle everything related to marketing our value proposition, proposal management, emphasizing our broad line of products and supporting all services our potential clients are seeking. 

The Pharmacy Proposal Manager will coordinate and produce proposal packages (RFP, RFI, RFQ) for full service PBM offerings or a la carte offerings. The proposal manager will lead, train, and develop the proposal team which includes a senior proposal writer and three proposal writers. The proposal manager will be a skilled thinker that can put value proposition narratives together to submit a winning proposal package. The proposal manager will support the sale process as well. Assisting the Business Development leadership team with sales presentations and demos, as necessary. Occasional travel for conferences, networking events, or onsite team building activities. Must have experience working under pressure and meeting tight deadlines. Must be willing to work evenings and weekends as needed.

The fundamentals for the job…

• Delivery of compliant, professionally produced proposals within customer defined timeframes
• Coordinate and review / edit proposal input from a variety of stakeholders, typically involving contributions from sales, marketing, product teams, finance, commercial, legal, and other departments
• Communicate and influence at a senior level
• Ability to coach team in persuasive writing and proposal best practice
• Ability to mentor, develop, and engage each direct report
• Management and oversight of proposal systems (SalesForce, Ombud, etc.)
• Management of all RFP marketing material and compliance with company branding
• Implementation hand off post sale
• Support client RFPs
• Manage relationships with consultants through RFP procurement process.
• Finalist and Sales Presentations
• Writing Executive Summaries
• Reporting of all department activity RFPs, projects, KPIs, etc.
• All other duties as assigned or needed.

What we expect of you

The bold requirements…

• Bachelor’s Degree or Master’s Degree. (In lieu of a degree, equivalent, relevant work experience may be considered).
• 8+ years of experience in proposal management, business development and/or sales.
• 5+ years of experience leading, developing and guiding teams reporting directly to you. 
• Experience using RFP Software or any other relevant software (RFP360, Proposal Tech)
• Experience applying problem solving and critical thinking skills
• Experience delivering presentations for stakeholders
• Excellent oral and written communication skills.
• We are proud to offer a flexible hybrid work model which will require certain on-site work days (Puerto Rico Location Only)

Nice to haves…

• APMP Foundation Certification.
• Bilingual fluency in English and Spanish.

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.

#LI-AMBT #LI-REMOTE 

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…

Making healthcare awesome is key to everything we do at Abarca, and so the Strategy to Execution team helps us reach those heights through service design, project and process improvement, and strategy planning! From Project and Process Improvement to Innovation and Business Enabling to Strategic Management, this team tackles existing and innovative programs or processes at Abarca to rethink, reshape and rework how we do what we do.

As our Business Partner, Project Management, you will manage multiple medium-sized projects or 1-3 highly complex and large-sized projects. You will have overall accountability for each assigned project and be responsible for project conception through completion, including scope, time, and budget, following our Project Management and Process Improvement methodology. You’ll be expected to document status, agreements and learnings from all meetings and presentations, and lead overall coordination, status reporting and stability of project work efforts.

The fundamentals for the job…

• In this role, you’ll be responsible for managing multiple medium-sized projects or 1-3 highly complex large-sized projects.
• You are to oversee overall coordination, status reporting and stability of project work efforts.
• You’ll establish and implement management processes and methodologies to ensure projects are delivered on time, within budget, adhere to high quality standards and meet expectations.
• You get to define the scope, develop plans, manage milestones, develop, and carry out appropriate communication plans with stakeholders; you also develop relationships with cross functional partners and align project timelines to ensure they are completed meeting stakeholder needs.
• Assemble project plans and teamwork assignments, direct and monitor work on a daily basis, identify resources needed, perform quality reviews, and escalate functional, quality, and timeline issues appropriately.
• Keep track of key milestones and adjust plans and/or resources to meet customer needs.
• Schedule and monitor project deliverables.
• Coordinate communication with all areas that impact the scope, budget, risk, and resources of the project.
• Manage and update project plan using Microsoft Project tool and keep team informed of status and deliverables.
• Provide weekly/monthly/quarterly progress reports to management, as needed.
• Provide oversight and leadership in executing projects from planning to completion to provide results to the business​.
• Assess, prioritize, and provide a health check report of active projects.
• Provide advice to optimize business performance and assist in the development of the department’s strategy​.
• Provide operational process improvements, identifying, analyzing & improving current business processes to optimize performance, meet best practices & improve quality.
• Work in tandem with other teams to automate processes, improve functionality, identify inefficiencies and areas for improvement, and drive advances that impact both, the team’s performance as well as the client expecting deliverables.
• Provide education, training and presentation of project updates, new processes, and tools for users.
• Be generally amazing and awesome to the point that people want to work projects of which you are in charge.
• Perform any other tasks or special projects as assigned.

What we expect of you

The bold requirements…

• Bachelor or Master’s Degree Engineering, Business or Economics (In lieu of a degree, equivalent relevant experience may be considered.)
• 3+ years of experience in consulting, engineering, and project management teams.
• Experience with data analytics tools (e.g. Excel, Tableau, PoweBI)
• Experience leading cross-functional initiatives, driving performance, and executing on deliverables while leveraging tools and techniques.
• Experience in leveraging excellent communication to achieve commitment from stakeholders, good organizational skills for projects and problem-solving experience when issues arise.
• Excellent oral and written communication skills, bilingual fluency in Spanish and English is required.
• We are proud to offer a flexible hybrid work model which will require certain on-site workdays (Puerto Rico Location Only)

Nice to haves…

• PMI Credential (PMP, PgMP, PMI-ACP, PMI-SP, or PMI-RMP).
• Experience with Microsoft Projects Server.
• Experience in health insurance or PBM setting managing projects.

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.

#LI-REMOTE #LI-BM1 

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…

Our Operational Performance team is #All-In on centralizing data to dive through and study as they work on improving operations at Abarca. The Performance Monitoring team has the metrics tracking down from OKRs to KPIs and proactively manages shortfalls to ensure we continuously set and reach the highest standards. That's why performance is part of their name as they help drive both scalability and efficiency across the board!

As our Service Level Analyst, you will play a critical role in monitoring, analyzing, and reporting on service level agreements (SLAs) to ensure the organization meets its commitments to customers and clients. This role involves data analysis, reporting, and collaboration with various teams to maintain high service quality and customer satisfaction.

The fundamentals for the job…

• Tracks that Performance Guarantees (PG) reports are produced for each customer service. Documents overall compliance of SLAs by client/area.
• Analyze data to identify trends, areas of improvement, and/ or opportunities to enhance service delivery.
• Performs gap analysis to highlight breaches of SLA targets, investigating reasons and recommending improvement actions to PG owners to prevent their recurrence (collaboration with Performance Oversight team). Triggers and collaborates with PG owners on Improvement Action Plan process once criteria are met.
• Monitors PG owners Improvement Action plan completion and results.
• Executes periodic process audits to ensure reporting methodology accuracy.
• Monitor adherence to client service level agreement by reviewing documentation supplied by operations and technology teams.
• Generate regular reports on service performance and SLA adherence.
• Maintain accurate records of SLAs, service metrics, and performance data.
• Ensure documentation is up-to-date and readily accessible.
• Assist in the implementation of service improvement initiatives and projects.
• Provide data-driven insights to support continuous service quality enhancements.
• Identify and report potential risks to SLA attainment.
• Collaborate on strategies to mitigate risks and ensure consistent service quality.
• Provide necessary data and reports needed for the Performance Guarantee committee.

What we expect of you 

The bold requirements…

• Bachelor’s or Master’s Degree in Business Administration, Science, or related field (In lieu of a degree, equivalent relevant experience may be considered.)
• 3+ years of experience in experience in contract and vendor management, corporate affairs and/or related fields.
• Experience and solid expertise in project planning, data management, data analysis, and reporting.
• Experience in leveraging excel for reporting and business analytics.
• Excellent oral and written communication skills.
• We are proud to offer a flexible hybrid work model which will require certain on-site workdays (Puerto Rico Location Only)

Nice to have….

• Experience with Experience with the Healthcare, Pharmacy, and Pharmacy Benefit Management industries, Medicare Part D, and CMS regulations.
• Experience with SQL Queries, PowerBi, Microsoft Visio and other visual documentation or analytics tools.

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.

#LI-JD1 #LI-REMOTE

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…

Our Sales and Business Development gurus are the welcoming heralds for any potential client! They're entrusted with developing the strategy operational relationships that are needed to extend our superior quality, processes, and aid to new beneficiaries. They handle everything related to marketing our value proposition, proposal management, emphasizing our broad line of products and supporting all services our potential clients are seeking. 

As Proposal Writer you will collect accurate and timely information that is relevant to bid specifications and platforms from the subject matter experts and will support proposal development in any way needed to meet on-time delivery. You can put your creative juices to good use making sure that proposals present Abarca in a manner that differentiates the company from the rest and clearly articulates our value proposition. We expect quality, on-time proposals that have a high degree of probability to make it to the final stages of selection.

The fundamentals for the job…

• Lead, coordinate, write and edit all delegated proposals from start to finish.
• Engage and collaborate with key Subject Matter Experts (SME’s) to produce and improve Abarca’s Proposal content to maximize the chances of delivering winning proposals.
• Edit and revise proposals according to feedback.
• Review products, services, and business ideas to package the content in a manner that persuades and influences prospects.
• Attend and lead meetings as needed to support successful execution of the proposal package.
• Maintain our library of response system and close out proposals in the system.
• Maintain and update any documentation and exhibits as necessary or required for the proposal.
• Follow company and department policies to maintain consistency in proposal writing and meet regulatory requirements.

What we expect of you

The bold requirements…

• Bachelor’s Degree or Master’s Degree in English, Journalism, Marketing, Pharmacy or Healthcare Administration. (In lieu of a degree, equivalent, relevant work experience may be considered).
• 3+ years of experience in pharmacy or proposal writing with a focus in managed care, healthcare, or pharmacy benefit management.
• Experience with project management, process improvement, and agile methodologies.
• Experience collaborating with multi-functional teams to develop a customer-specific proposal strategy.
• Experience creating new proposal text by meeting with subject matter experts or using reference documents.
• Experience with Salesforce
• Experience with Ombud or other Request for Proposal (RFP) software management tools 
• Excellent oral and written communication skills.

Nice to haves…

• Experience in pharmacy benefit management and commercial background.
• Experience and comfort with presentation and public speaking.
• Experience analyzing compliance-driven and technical documentation to determine customer requirements and understand complex customer issues within the public sector, or pharmacy areas.
• Bilingual fluency in English and Spanish.

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.

#LI-AMBT #LI-REMOTE