Hybrid Pharmacy Credentialing & Licensing Specialist

The Elevance Health Companies, Inc.; Town of Florida (NY); Hybrid; USD 60,000 - 90,000; Full time

Job summary

Elevance Health is seeking a Pharmacy Credentialing/Licensing Analyst to support license tracking, renewal submissions, and credentialing processes for pharmacy sites. The role requires collaboration with managed care plans and state agencies, with hybrid in-office requirements at least 1–2 days per week and a Florida site focus.

Applicants should have a high school diploma and at least 3 years of related experience; familiarity with Medicaid/Medicare and PBM programs is preferred, and the team

Qualifications

• Requires a H.S. diploma and minimum of 3 years' experience; or any combination of education and experience, which would provide an equivalent background.
• Preferred experience with pharmacy licensure with state boards is strongly preferred.
• Knowledge of Medicaid, Medicare, Managed care and PBM providers is preferred.

Responsibilities

• Manage and maintain pharmacy license tracking tool and inform sites and pharmacists of renewals.
• Submit new pharmacy license applications and renewals for all sites.
• Maintain confidentiality of all pertinent pharmacy and provider information.
• Administer credentialing and re-credentialing to ensure compliance with policy and standards.
• Develop relationships with managed care plans and state agencies to facilitate credentialing.
• Track credentialing to ensure timely submissions.
• Maintain credentialing files (electronic and paper).
• Communicate with admissions, billing, and clinical teams professionally.
• Review credentialing policies for accuracy and completeness; suggest revisions.
• Complete Medicaid applications and renewals; manage Medicaid portal.
• URAC, ACHC, NABP support during accreditation renewals.
• Submit Pharmacist in Charge license changes and renewals.

Skills

Pharmacy licensure

Credentialing

Regulatory knowledge

Data confidentiality

Education

High School Diploma

Tools

Medicaid portal

NCPDP profile

NPI updates (NPPES)

Job description

Elevance Health is seeking a Pharmacy Credentialing/Licensing Analyst to support license tracking, renewal submissions, and credentialing processes for pharmacy sites. The role requires collaboration with managed care plans and state agencies, with hybrid in-office requirements at least 1–2 days per week and a Florida site focus.

Applicants should have a high school diploma and at least 3 years of related experience; familiarity with Medicaid/Medicare and PBM programs is preferred, and the team