Overview
Remote
$70 - $100
Accepts corp to corp applications
Contract - Independent
Contract - W2
Skills
Pharmacy Benefits
Resolute PB Administrator
Epic Pharmacy
Job Details
Job Title: Epic Resolute PB (Pharmacy Benefits) Administrator
Mode of work: Remote
Job Summary:
We are seeking an experienced Epic Resolute PB Administrator to manage and support the Epic Pharmacy Benefits module within the healthcare system. The ideal candidate will ensure the accurate configuration, maintenance, and optimization of pharmacy benefit workflows to support claims processing, reimbursement accuracy, and operational efficiency.
This role requires Epic certification in Resolute PB or related Epic Pharmacy modules and a strong understanding of PBM (Pharmacy Benefit Management), claims adjudication, and healthcare payer operations.
Key Responsibilities:
- Administer and maintain the Epic Resolute PB module, including system configuration, benefit plan setup, formulary maintenance, and reimbursement rules.
- Collaborate with pharmacy operations, revenue cycle, and IT teams to ensure seamless pharmacy benefit management and claims processing.
- Monitor and resolve system issues, configuration errors, and discrepancies in benefit or pricing setup.
- Perform routine system maintenance, testing, and validation during upgrades, patches, and new releases.
- Support end users by troubleshooting issues and providing workflow or functionality guidance.
- Document system configurations, workflows, and standard operating procedures to ensure compliance and continuity.
- Work closely with Epic Analysts and administrators to align pharmacy benefit processes with organizational policies and regulatory requirements.
- Participate in system optimization initiatives, analyzing data to improve performance and efficiency in claims adjudication and PB workflows.
- Ensure HIPAA compliance and maintain data security standards across all pharmacy benefit processes.
Required Qualifications:
- Epic Certification: Epic Resolute PB Administrator (or combination with Epic Resolute Professional Billing, Pharmacy, or other relevant certifications).
- Experience: 3 5+ years in Epic application support or system administration, specifically in Resolute PB or Pharmacy Benefits.
- Knowledge of pharmacy benefit structures, PBM processes, formulary management, NDC mapping, and claims adjudication.
- Strong understanding of Epic master files, workflows, and integration points across pharmacy and billing modules.
- Excellent analytical, troubleshooting, and documentation skills.
- Strong collaboration and communication abilities to coordinate across clinical, operational, and technical teams.
Preferred Qualifications:
- Previous experience in healthcare IT or revenue cycle operations within a payer or provider setting.
- Familiarity with Epic Clarity Reporting, SQL, or data analysis tools.
- Knowledge of regulatory standards (HIPAA, CMS, NCPDP, etc.).
- Experience supporting Epic upgrade cycles and user acceptance testing (UAT).
Key Epic Certification Options (Any of the Below or Combinations):
- Epic Resolute PB Administrator
- Epic Resolute Professional Billing (PB)
- Epic Pharmacy
- Epic Benefits Engine
- Epic Claims or Revenue Cycle certifications
Employers have access to artificial intelligence language tools (“AI”) that help generate and enhance job descriptions and AI may have been used to create this description. The position description has been reviewed for accuracy and Dice believes it to correctly reflect the job opportunity.