Prime Therapeutics - Saint Paul, MN

posted 4 days ago

Full-time - Entry Level
Remote - Saint Paul, MN
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.
  • Serve as a liaison for field staff, resolving problems and complaints related to credentialing and contracting.
  • Coordinate state Fee For Service client's pharmacy network enrollment as assigned.
  • Oversee EFT and 835 remittance enrollment and issue resolution.
  • Assist in developing commercial pharmacy networks and managing 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 and strong skills 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.
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