Remote Pharmacy Relations Specialist II - Contracts & Network

Florida Pharmacy Association, Inc.; Tallahassee (FL); Remote; USD 60.000 - 80.000; Vollzeit

Benefits dieser Stelle

Health, Dental & Vision

Paid time off: 20 days

Parental leave: 4 weeks

Paid holidays: 9

401(k) match up to 5%

Adoption assistance

Flexible Spending Account

Education & Professional membership支持

Referral bonus up to $750

Zusammenfassung

Navitus Health Solutions is seeking a Pharmacy Relations Specialist to join our team. The role focuses on contracting with independent pharmacies and select networks, while ensuring compliance with network agreements and supporting audits and claims processes.

Ideal candidates have at least 2 years in pharmacy settings or with pharmacies, strong Microsoft Office skills, and experience analyzing claims. This position offers remote work options and a comprehensive benefits package.

Qualifikationen

• College or 2-year technical degree or equivalent experience preferred.
• Certified Pharmacy Technician preferred.
• 3 years business-setting experience.
• Retail pharmacy or managed care setting experience desired.
• Experience analyzing medical/pharmacy claims or credentials desired.
• Proficient in Microsoft Office and industry related software.
• Participate in, adhere to, and support compliance program objectives.
• Ability to interact cooperatively and respectfully with colleagues.

Aufgaben

• Manage pharmacy contracting process with independent pharmacies and select chains/PSAOs and assist management with network negotiations; inclusive of redline reviews
• Review pharmacy contract setup to ensure compliance with pharmacy network agreements
• Support pharmacy audits and network compliance initiatives
• Research and problem solve to resolve claim issues and concerns
• Respond to and track requests, inquiries, and communications with network pharmacies
• Develop, review, and distribute pharmacy communications to meet internal and client requests
• Monitor, track, and report pharmacy compliance with guiding government regulations and internal policies and procedures
• Reviews and responds to independent pharmacy redlines; with little to no input from senior leadership
• Responsible for all aspects of maintenance related to pharmacy network functions, such as, network plan design builds, quality assurance measures and claims processing in general
• Other duties as assigned

Kenntnisse

Pharmacy contracting

Certified Pharmacy Technician

Microsoft Office

Claims analysis

Compliance awareness

Interpersonal skills

Industry software

Ausbildung

College or 2-year technical degree

Certified Pharmacy Technician

Tools

Industry related software

Jobbeschreibung

Navitus Health Solutions is seeking a Pharmacy Relations Specialist to join our team. The role focuses on contracting with independent pharmacies and select networks, while ensuring compliance with network agreements and supporting audits and claims processes.

Ideal candidates have at least 2 years in pharmacy settings or with pharmacies, strong Microsoft Office skills, and experience analyzing claims. This position offers remote work options and a comprehensive benefits package.