Careers at abarca health

Mission

abarca health provides pharmacy benefits management solutions to lower cost, improve benefits, and streamline operations.

Product Segments

abarca has designed a pharmacy benefit management technology platform to maintain the best value for their clients’ drug benefits. Through the Benefit Design and Management service, pharmacies can design and setup their benefit structure. They can manage eligibility for benefits, process transactions, and make claim adjustments. Pharmacy programs may be customized with discount cards, savings clubs, or loyalty programs.

With Formulary and Pricing Management pharmacies can regulate their pharmacy benefits. Guidance is provided for the formulary development, management and submissions of prescription drug coverage. abarca assists with the management of Pharmacy and Therapeutics (P&T) committees, which decides the drugs that may be prescribed. Their services include rebate negotiation, and the handling of billing or collections. They also develop and maintain any Maximum Allowable Cost (MAC) lists.

The Clinical and Utilization Management Services help evaluate and sustain health care procedures and facilities. Pharmacies can manage their medication therapy by viewing prior authorizations and reviewing drug utilization. Determinations can be made regarding coverage or exceptions to coverage. Educational outreach to prescribers and adherence to medication programs can be facilitated.

The Provider Network Management covers the development and maintenance of the Retail Pharmacy Network. Mail order or specialty pharmacy programs will be processed and managed. abarca also handles any provider audits.

abarca’s Beneficiary Services include a call center that provides customer support. Benefits cards will be generated and distributed through the service. Members may be provided an orientation and receive communication regarding their treatment. They may also participate in clinical interventions or file grievances and appeals.

History

abarca was found by Jason Borschow in 2005. Borschow was previously responsible for managing Puerto Rico's largest retail pharmacy distribution business, Borschow Drug, as Vice President. abarca health provides pharmacy benefits management and health information technology to improve the healthcare experience.

By utilizing its customized information systems, abarca health collaborates with its customers to help manage healthcare costs, increase the quality of care, enhance benefit programs, and streamline operations. The company designs, administers and supports premium quality pharmacy benefit programs for health plans, government programs, self-insuring employer or union groups, and other healthcare recipients. Their focus is on using timely data and innovative technology to help payers, patients, and providers make better healthcare decisions.

abarca serves more than 2 million people and helps manage over $950 million a year in pharmaceutical spending. Their team includes healthcare and information technology professionals such as medical doctors, pharmacists, nurses, health educators, engineers, software developers, actuaries, and economists. The company operates out of San Juan, Puerto Rico.