Specialist II, Pharmacy Relations
New
N
NavitusPharmacy benefits
Navitus is only able to offer remote work to residents of Alabama, Arizona, Arkansas, California, Colorado, Connecticut, Delaware, Florida, Georgia, Idaho, Illinois, Indiana, Iowa, Kansas, Kentucky, Louisiana, Maryland, Massachusetts, Michigan, Minnesota, Missouri, Montana, Nebraska, Nevada, New Jersey, New York, North Carolina, Ohio, Oklahoma, Oregon, Pennsylvania, Tennessee, Texas, Utah, Vermont, Virginia, Washington, Washington DC, Wisconsin.Full-TimeJunior
SalaryUSD $48,729.00 - USD $58,010.00 /Yr. STAR Bonus % (At Risk Maximum) 7.50 - Salaried Non-Management except pharmacists
Apply NowOpens the employer's application page
Job Details
- Experience
- At least 2 years of successful experience working in a pharmacy or interfacing directly with pharmacies or accounts, preferably in healthcare; 3 years business-setting experience.
- Required Skills
- Microsoft Office
Requirements
- Have at least 2 years of successful experience working in a pharmacy or interfacing directly with pharmacies or accounts; healthcare experience is preferred.
- Have 3 years of business-setting experience.
- A college or 2-year technical degree or equivalent experience is preferred.
- Certified Pharmacy Technician certification is preferred.
- Retail pharmacy experience or experience in a managed care pharmacy setting is desired.
- Experience analyzing medical and/or pharmacy claims or credentials is highly desired.
- Be proficient in Microsoft Office and industry-related software.
- Participate in, adhere to, and support compliance program objectives.
- Interact cooperatively and respectfully with other employees.
Responsibilities
- Manage contracting with independent pharmacies and select chains or PSAOs, and assist management with network negotiations, including redline reviews.
- Review pharmacy contract setup for compliance with pharmacy network agreements.
- Support pharmacy audits and network compliance initiatives.
- Research and resolve pharmacy claim issues and concerns.
- Respond to, track, and manage requests, inquiries, and communications with network pharmacies.
- Develop, review, and distribute pharmacy communications for internal and client requests.
- Monitor, track, and report pharmacy compliance with government regulations and internal policies and procedures.
- Review and respond to independent pharmacy redlines with little to no input from senior leadership.
- Maintain pharmacy network functions, including network plan design builds, quality assurance measures, and claims processing.
View Full Description & ApplyYou'll be redirected to the employer's site
