Pharmacy Network Administrator - Remote in the California market

$43,181 - $64,771/Yr

Prime Therapeutics - Frankfort, KY

Full-time

Remote - Frankfort, KY

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 network operations.

Responsibilities

• Manage a variety of credentialing and contracting projects, including coordination with third-party vendors and provider communications.
• Create, design, test, and implement specific production and audit reports.
• Set up and support pharmacy payment center operations, including contract rollout and special mailings.
• Serve as a liaison to field staff for assigned geographic locations, resolving problems and provider issues.
• Coordinate state Fee For Service client's pharmacy network enrollment as assigned.
• Handle all EFT and 835 remittance enrollment and issue resolution.
• Assist in the development of commercial pharmacy networks and manage network databases.
• Perform other duties as assigned.

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.
• Ability to identify barriers and elevate issues effectively.
• Strong interpersonal and communication skills, both written and verbal.
• Ability to establish strong relationships and influence work performance of others.
• Intermediate MS Excel skills and strong 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 from $20.76 - $31.14 based on experience and skills.
• Diverse and inclusive work environment.
• Opportunities for career advancement within a growing company.