إنتهت صلاحية هذا الإعلان الوظيفي لقد إنتهت صلاحية هذا الإعلان الوظيفي و هو غير مفتوح حاليا لأي طلبات عمل.
إرفاق
وصف الوظيفة
To manage deliverables and activities that ensure the effectiveness of the Pharmaceutical Benefit Management system by identifying the opportunities for improvement with the objective of providing the best clinical outcomes and cost-effective care for members.
Pharmaceutical data Analysis and management
- Design data models to integrate patient data from multiple sources to create complete views of pharmaceutical data and quantify the management of clinical and pharmaceutical rules at medication level.
- Develop quantified waste for medication errors, overutilization, inappropriate clinical and pharmaceutical management.
- Conduct retrospective pharmaceutical statistical analysis annually for all medications.
- Conduct in-depth analysis of pharmaceutical claims and PA data to identify trends and opportunities for improvement.
- Conduct feasibility and impact studies for the clinical and cost management initiatives.
- Deliver pharmaceutical reports for mega accounts to monitor their medication utilization.
- Validate all pharmaceutical analysis for other business units.
PBM Operations
- Oversee PBM operations and initiate problem resolution.
- Collaborate with stakeholders to execute assigned objectives for PBM enhancements and implementation including system updates.
- Ensure compliance with regulatory requirements and pharmaceutical standards.
- Monitor and assess the effectiveness of PBM system and suggest improvements.
- Track PBM trends and initiatives currently taken and monitor the progress against each initiative.
Formularies Design
- Implement pharmaceutical updates that are identified by the system.
- Design different formularies lists that can include multiple tiers to promote the use of clinically appropriate, cost-effective, lower-cost generic medications.
- Collect medication availability data and log them in the system to amend deductibles accordingly.
Pharmaceutical network management
- Manage pharmaceutical networks with the support of PR team.
- Monitor providers’ medication practice in prescribing and dispensing medications.
- Review medication utilization for generics vs brands for specified providers for potential risks that can impact clinical, commercial and patients’ satisfaction levels.
Pharmaceutical Benefit management
- Identify the exclusion categories for medications based on the CHI policy.
- Maintain member pharmaceutical benefits lists with sales and enrolment teams.
- Verify the implementation of co-payment and deductibles based on the SFDA and CHI regulations.
المهارات
- Good MS Excel and Powerpoint skills
- Data analysis including healthcare claims data manipulation
- Ability to interpret both high level and detailed view of the data
- Good Power BI, SAS and Congos skills
- Excellent communication and presentation skills
المؤهلات العلمية
Doctor of Pharmacy
تفاصيل الوظيفة
المرشح المفضل
Bupa Arabia
Bupa Arabia is a healthcare insurance company based in the Kingdom of Saudi Arabia. We are an associate business of Bupa Group, which is a global healthcare company with an international reach that extends across multiple business operations, practices, and resources.
Founded in October 1997, Bupa Arabia was initially established through a partnership between Bupa Global International and Nazer Group, with the key focus to provide health insurance services with high quality and competitive prices, while ensuring a distinctive experience for customers. Bupa Arabia has since evolved into a fully Saudi-owned and operated company. Our transformation from a joint venture into a publicly traded company on the Saudi Stock Exchange occurred in 2008, as we made 40% of our shares available to the public during our Initial Public Offering (IPO).
As a subsidiary of the global Bupa Group, we draw upon international expertise while maintaining a profound understanding of local healthcare requirements and regulations. This allows us to offer comprehensive healthcare insurance solutions tailored to the unique needs of the Saudi Arabian market.
Bupa Arabia prides itself on its commitment to the wellbeing and development of its employees, providing them with the same standard of care, support, and professionalism that it expects to be delivered to its customers.
Our core values shape every aspect of our work and culture:
Commit – Own it with accountability and urgency.
Collaborate – Win together through cross-functional synergy.
Care – Put people first, both employees and customers.
