Pharmacy Network Administrator - Remote in the California market

$43,181 - $64,771/Yr

Prime Therapeutics - Jackson, MS

Full-time

Remote - Jackson, MS

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 related to provider credentialing, and acting as a liaison between internal and external stakeholders. The position requires strong analytical skills and the ability to communicate effectively with multi-disciplinary professionals to ensure compliance and efficiency in pharmacy network operations.

Responsibilities

• Manage credentialing and contracting projects, coordinating with third-party vendors and provider communications.
• Serve as a liaison to field staff for geographic locations, resolving problems and provider issues.
• Coordinate state Fee For Service client's pharmacy network enrollment as assigned.
• Oversee EFT and 835 remittance enrollment and issue resolution.
• Facilitate problem resolution in areas of risk and communicate concerns from field staff and State client contacts.
• 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.
• 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.
• Bachelor's degree preferred.

Nice-to-haves

• Pharmacy Benefits Management (PBM), managed care, or behavioral health experience 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.