Pharmacy Network Administrator - Remote in the California market

$43,181 - $64,771/Yr

Prime Therapeutics - Salem, OR

Full-time - Entry Level

Remote - Salem, OR

Administrative and Support Services

About the position

The Pharmacy Network Administrator serves as a key resource for credentialing and contracting projects within the pharmacy network. This role involves managing various projects, resolving issues, and facilitating communication between internal and external stakeholders to ensure compliance with credentialing and contracting requirements. The position is remote, specifically targeting the California market, and requires strong analytical and interpersonal skills to effectively support pharmacy operations.

Responsibilities

• Manage credentialing and contracting projects, coordinating with third-party vendors and provider communications.
• Create, design, test, and implement production and audit reports related to pharmacy payment center setup.
• Serve as a liaison to field staff, resolving problems, complaints, and provider issues using knowledge of credentialing and contracting information.
• Coordinate state Fee For Service client's pharmacy network enrollment as assigned.
• Handle EFT and 835 remittance enrollment and issue resolution.
• Assist in developing commercial pharmacy networks and managing network databases.

Requirements

• 1-3 years of experience in data management, credentialing, claims, insurance administration, or healthcare setting.
• Strong analysis and problem-solving skills.
• Ability to interface with multi-disciplinary high-level professionals.
• Strong interpersonal and communication skills, both written and verbal.
• Intermediate MS Excel skills and proficiency in other MS Office products.

Nice-to-haves

• Bachelor's degree preferred.
• Experience in Pharmacy Benefits Management (PBM), managed care, or behavioral health preferred.
• Experience utilizing quality improvement methodologies preferred.

Benefits

• Competitive pay range of $20.76 - $31.14 based on experience and skills.
• Comprehensive benefits package including health insurance, retirement plans, and paid time off.