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 Pharmacy Rebates Analyst, you will analyze rebate proposals and model the financial impact of formulary changes. Additionally, you will analyze rebate guarantee performance and identify drivers of underperformance. You will proactively evaluate utilization and rebate data to identify opportunities to optimize rebate performance.

The fundamentals for the job…

• Support all aspects of Rebates RFP process, including all operational interactions with pharmaceutical manufacturers.
• Log and track all rebate opportunities for Abarca clients.
• Model the financial impact of formulary coverage decisions in Excel to support client formulary decision-making.
• Use SQL and Tableau to analyze utilization trends and to pull data in support of rebate modeling.
• Present rebate models to clients and client account teams.
• Notify manufacturers about client formulary decisions.
• Maintain accurate records for internal auditing purposes.
• Load rebate agreements accurately into Darwin
• Validate client formularies to ensure compliance with rebate contracts.
• Validate that rebate invoicing is accurate and consistent with our rebate agreements.
• Support clinical and client engagement teams with questions about rebate contracts and eligibility.
• Lend a hand with special projects and provide support on all company audits related to rebates billing.

What we expect of you

The bold requirements…

• Bachelor’s Degree or Master’s Degree in Economics, Math, Finance, Business or a related field. (In lieu of a degree, equivalent relevant work experience may be considered.)
• 3+ year of experience in an analytical role 
• Experience with Microsoft Excel
• Experience performing critical analysis of datasets, visuals and dashboards.
• 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…

• Experience within the pharmacy benefit management or healthcare Industry.
• Experience with prescription drugs, pharmaceutical manufacturers, drug rebates and contract negotiations.
• Experience working with SQL and Tableau.

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

We’re seeking individuals who are passionate about making a meaningful impact on how people experience pharmacy care. Below are two career paths within our pharmacy call center where your background and skills may align with current or future opportunities as they arise.

Coverage Determination 

As a Coverage Determination Specialist you will be responsible to create and evaluate coverage determinations for our clients’. You will communicate with pharmacists, beneficiaries, and doctors regarding pending coverage determinations for our clients’ beneficiaries, applying clinical knowledge in each coverage determination case. You must comply with all federal rules and regulations, and client contracts and have disposition to give an extra mile in every coverage determination case. Main duties include:                                 

• Review and Respond to all Coverage Determination (CD) requests, and claims pending to be adjudicated for Medicare and/or Commercial-plan beneficiaries, always in an accurate and timely manner.
• Receive calls from pharmacies, physicians and members in relation to status of CD requests.
• Initiate calls to physicians, pharmacy and members when additional information is required for processing and adjudicating a CD request.
• Generate calls, faxes and/or letters to pharmacies, physicians and members in reference to coverage determination requests’ resolutions.
• Document Coverage Determination (CD) request inquiries, issues, status and resolution in accordance with federal and department / company policies and guidelines.
• Review faxes and emails and create new cases for Medicare/Medicaid or Commercial plans.
• Support Pharmacists in gathering additional information to support the decision of making an exception (formulary, non-formulary or other requests).
• Ensure Medicare & Medicaid Services (CMS) Compliance or other regulating entities related to coverage determinations.
• Complete other Coverage Determination related tasks, as assigned.

Rx Customer Service

As an 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 Rx Platform and other resources as necessary to resolve caller’s needs. Main duties include:       

• 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.

The Bold Requirements...

• Associate degree in Pharmacy Technician. 
• 1+ years of experience in customer service.
• Experience with Microsoft Office tools (Outlook, Excel, Power Point, and Word).
• Excellent oral and written communication skills. Fluency in English and Spanish is required.
• Available to work rotating shifts, including nights, weekends, and holidays.
• Available to work in a hybrid work model which will require certain on-site workdays.

Nice to have…

• Certified Pharmacy Technician License is preferred.
• Experience in healthcare or pharmacy setting is a plus. 

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

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”.

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-HYBRID #LI-MH1

About the Role 

We’re looking for a Senior Associate Software Engineer to join our growing team. In this role, you’ll build and deploy AI-powered, production-grade software systems within client environments. You’ll operate at the intersection of software engineering, data systems, and applied AI, translating complex business problems into scalable, reliable solutions. 

This position is ideal for engineers who enjoy hands-on system building, working closely with clients, and shaping technical direction and best practices across projects. 

What You’ll Do 

• Collaborate with cross-functional teams to define business and technical requirements 

• Partner on design and build data pipelines that ingest, transform, and deliver data from source systems to analytical platforms using modern cloud technologies 

• Support on design and implement infrastructure and data platforms that enable reliable access, transformation, and analysis of data 

• Document and maintain data architecture to support reliable, scalable data systems 

• Contribute to improving engineering practices around quality, maintainability, and operational stability 

• Mentor and support other engineers through code reviews, design discussions, and day to-day collaboration 

What We’re Looking For 

Required Qualifications 

• 4+ years of professional software engineering experience, including backend and/or data engineering 

• Experience delivering production systems in environments with evolving or changing requirements 

• Experience building and maintaining APIs and backend services (e.g., FastAPI, Node.js, or similar frameworks) 

• Strong experience with SQL and relational or analytical data systems 

• Experience working in cloud environments (AWS, Azure) 

• Experience with modern engineering workflows, including Git-based version control and CI/CD pipelines 

• Good understanding of software engineering best practices, testing strategies, and agile delivery 

• Strong written and verbal English communication skills 

Preferred Qualifications 

• Hands-on experience building and deploying AI-enabled systems, particularly LLM-powered workflows and orchestration (e.g., LangChain, LangGraph) 

• Familiarity with Infrastructure as Code tools (e.g., Terraform) 

• Background in designing and maintaining data pipelines or data-intensive systems 

• Exposure to data warehouses or large-scale analytical platforms 

• Knowledge of workflow orchestration or distributed processing systems