Pharmacy Network & Contracts Lead

ProCare Rx; Gainesville (GA); On-site; USD 55,000 - 75,000; Full time

Benefits offered by this job

Health benefits

Vacation

Wellness program

401(k) match

EAP

Referral bonus

Job summary

ProCare Rx is seeking a qualified professional to manage the contract lifecycle and strengthen pharmacy networks. You will support day-to-day pharmacy inquiries by phone and email, drive network development efforts, and track contracts from draft to execution.

The role requires strong attention to detail, excellent communication, and the ability to work across multiple systems. Experience with provider relations or PBM contracts is preferred, with opportunities to contribute to URAC

Qualifications

• Associate's Degree with two years of experience in a health care setting working with contracts and/or provider relations preferred.
• PBM experience is a plus.

Responsibilities

• Support day-to-day operational support for pharmacy questions via phone and/or email.
• Handle Network Development emails; respond to requests and questions from pharmacies.
• Initiate and tracks contract from initial draft to full execution.
• Provide written and/or verbal contractual education for pharmacies as needed.
• Target and recruit additional pharmacies to meet Plan network adequacy requirements.
• Participate in re-contracting efforts as required and directed.
• Shepherd contracts through negotiation for independent pharmacies and small chains.
• Lead Hospice Contracting initiatives.
• Update multiple systems with contract data and demographic information.
• Submit pricing changes to the Quality Assurance team.
• Assist in RFP responses.
• Maintain the Pharmacy Administrative Manual (PAM).
• Work with Credentialing Specialist to ensure credentialing standards are met.
• Investigate pharmacy claim issues; pricing complaints and perform Pricing Escalation triage.
• Communicate with the MAC/Reimbursement team as required.
• Attend GER review call and implement system changes.
• Attend meetings for new plan implementations.
• Ensure deliverables are on time and meet quality levels.
• Coordinate and follow up on pharmacy network communications.
• Oversee monthly import reports and weekly data cascading.
• Prepare documentation for audits (URAC accreditation).

Skills

Team player

Multitasking

Phone etiquette

Detail oriented

Communication

Tech proficiency

Education

Associate's Degree

Tools

Microsoft Word

Excel

Adobe

Outlook

Job description

ProCare Rx is seeking a qualified professional to manage the contract lifecycle and strengthen pharmacy networks. You will support day-to-day pharmacy inquiries by phone and email, drive network development efforts, and track contracts from draft to execution.

The role requires strong attention to detail, excellent communication, and the ability to work across multiple systems. Experience with provider relations or PBM contracts is preferred, with opportunities to contribute to URAC