Pharmacy Relations Specialist
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Job Description
Pharmacy Relations Specialist managing pharmacy contracts, provider issues, and network accuracy. Supporting Navitus’s pharmacy benefit management operations and provider communications.
Responsibilities:
- Make decisions regarding the resolution of pharmacy issues
- Establish and maintain contracts with pharmacy providers
- Facilitate submittal, receipt, tracking, and process flow of contracts between Navitus and providers
- Accurately enter information and maintain contract database
- Generate reports on network performance to monitor claims accuracy throughout the terms of the contract
- Create networks based on contract terms within the claims processing system and ensure accuracy by performing quality reviews
- Assist in resolving intricate pharmacy provider issues and complaints
- Coordinate pharmacy network communication efforts, including collecting content, disseminating information to provider partners through appropriate channels, and tracking response metrics
- Perform other duties as assigned
Requirements:
- At least 3 years of successful experience working in a pharmacy or interfacing directly with pharmacies or accounts, preferably in healthcare
- College or 2-year Technical Degree or equivalent experience is preferred
- Advanced technical education a plus
- Certified Pharmacy Technician license preferred
- 1-3 years of successful experience in a customer service role
- Knowledge of PBM or health care industry preferred
- PC skills: Microsoft Office, Email, Internet, and other applications as require
- Participate in, adhere to, and support compliance program objectives
- Ability to consistently interact cooperatively and respectfully with other employees
- 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, or Wisconsin
Benefits:
- Top of the industry benefits for Health, Dental, and Vision insurance
- 20 days paid time off
- 4 weeks paid parental leave
- 9 paid holidays
- 401K company match of up to 5% - No vesting requirement
- Adoption Assistance Program
- Flexible Spending Account
- Educational Assistance Plan and Professional Membership assistance
- Referral Bonus Program – up to $750!
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