Abarca Health Jobs & Careers - Remote Work From Home & Flexible

• US National

Lead and strategically manage teams within the configuration services department. Serve as a subject matter expert on pharmacy benefit configuration processes. Collaborate with cross-functional teams to plan and execute projects and deliver high-qual..

• US National

Oversee timely and accurate submission of PDE data, ensure reconciliation of PDE data, monitor and report on PDE data quality metrics, and lead a team of PDE analysts providing guidance, mentorship, and support. Stay up to date with Medicare Part D r..

• San Juan, Puerto Rico

Analyze healthcare claims data, perform root-cause analysis, and communicate results to clients. Develop analytics solutions, mentor junior analysts, and ensure data integrity for Health Analytics projects.

• San Juan, Puerto Rico

Create and evaluate coverage determinations for clients. Communicate with pharmacists, beneficiaries, and doctors regarding pending coverage determinations. Ensure compliance with federal rules and regulations, client contracts, and give extra effort..

• US National

Lead, coordinate, write and edit proposals from start to finish. Collaborate with SMEs to produce and improve proposal content. Attend meetings as needed to support successful execution of the proposal package.

• US National

Support the Knowledge Accelerator team in creating content, as needed, for training on subject matter expertise and process. Collaborate with peers as technical subject matter expert and go to person supporting requests as needed.

• San Juan, Puerto Rico

Manage incoming calls, emails, faxes, and web requests from pharmacies, beneficiaries, and prescribers. Meet service-level standards set by CMS or the client. Address customer complaints, payment status, reversal requests, eligibility support, provid...

• US National

Manage client benefit requirements, engage in client requirement sessions, collaborate with cross-functional teams, and provide client demos. Bachelor's or Master's degree and healthcare experience required.

Subject matter expert for product domains. Create and refine business requirements, collaborate with other Product Owners and Managers, gather requirements, analyze business solutions, develop acceptance criteria, and support product domain.

• Puerto Rico, or US National

Collaborate on the design, build, and maintenance of reliable and scalable infrastructure and software systems. Track error budgets against service level agreements and identify opportunities for improvement in terms of reliability.

• US National

Debug and propose solutions for software issues, assist customers with platform functionalities, troubleshoot technical problems, collaborate with development teams, maintain documentation, provide support, and stay updated on issues and processes.

• US National

Lead and mentor a team of DevOps Engineers. Collaborate with Agile Team members to establish best practices. Enhance CI/CD pipelines to support new deployment targets. Troubleshoot existing information systems for errors and resolve configuration issues.

• US National

Coordinate and produce proposal packages for full service PBM offerings or a la carte offerings, lead and develop a proposal team, support the sales process, and manage relationships with consultants through the RFP procurement process.

• San Juan, Puerto Rico

Assist in Medication Therapy & Disease Management by discussing medical histories, conditions & treatments with beneficiaries. Educate them about medication indications & safety while staying updated on drug therapies & chronic condition management.

• US National

Optimize testing and monitoring activities for systems and processes, develop test plans and execute test cases based on business requirements, analyze and report on test results, collaborate with teams to improve testing strategies and tools.

• San Juan, Puerto Rico

Collaborate with leadership to develop talent acquisition strategies aligned with long-term goals. Manage end-to-end recruitment process, build relationships with hiring managers, ensure positive candidate experience, and support onboarding activities.

• Puerto Rico, or US National

Manage client relationships, operational calls, and requests. Coordinate with internal teams to ensure timely completion of deliverables. Develop dashboards and reports to track client SLAs. Bachelor's degree and 3+ years of account management experi..

• San Juan, Puerto Rico

Design and develop reporting and analytic solutions, convert project specifications into interactive user interfaces, analyze data sets to identify trends and opportunities for optimization, present analysis and reports to stakeholders.

• San Juan, Puerto Rico

Analyze rebates invoices, generate reconciliations, and design tools to ensure accuracy of data. Collaborate with stakeholders to identify data and analytics solutions, automate processes, and provide analytical support for rebates management.

• San Juan, PR, Puerto Rico

Credentialing Analyst responsible for maintaining and updating credentialing database, conducting ongoing credentialing processes, ensuring compliance with regulations, assisting in trainings, and providing support to Network Strategy team.

• US National

Monitor, analyze, and report on service level agreements. Analyze data to identify trends and areas for improvement. Generate regular reports on service performance and collaborate on service improvement initiatives.

• San Juan, Puerto Rico

Develop and maintain pharmacy network strategies, establish and maintain relationships with pharmacy chains and national pharmacy organizations, troubleshoot network-related issues, assist with contract negotiation, and support day-to-day Provider Re..

• US National

Implement and update benefit plan setups for clients, perform configuration testing, triage operational issues, and analyze and resolve gaps. Requires a degree, 3+ years of experience, and knowledge of SQL and Excel.

• San Juan, Puerto Rico

Assist in analyzing company performance and preparing financial reports. Maintain accounting software integrity. Prepare journal entries and validate assumptions for budget and forecast preparation. Support FP&A analysts with internal reporting requests.

• US National

Review legislation and regulations, assess impact on company, oversee implementation of legal requirements. Provide counsel on proposed legislation, assess risks, draft responses to inquiries regarding legal requirements.

• US National

Support modernization and optimization of Security policies and procedures. Assist in developing and enhancing security GRC processes. Participate in vulnerability assessments and HITRUST certifications to support security and compliance maturity.