ESSENTIAL DUTIES AND RESPONSIBLITIES include but are not limited to the following:
- Provide day-to-day operational support for pharmacy questions via phone and/or
- Responsible for Network Development emails; respond to requests and questions from pharmacies in a timely
- Initiate and tracks contract from initial draft to full
- Provide written and/or verbal contractual education for pharmacies as
- Target and recruit additional pharmacies to meet Plan network adequacy requirements and/or
- Participate in re-contracting efforts as required and
- Update multiple systems with contract data and demographic information as
- Submit pricing changes to the Quality Assurance
- Work with the Credentialing Specialist to ensure credentialing standards are
- Investigate simple pharmacy claim issues help resolve pharmacy issues and
- Communicate with the MAC/Reimbursement team as
- Prepare documentation for audits as requested by
- Attend meetings for new plan
- Ensure deliverables are on time and meet quality levels as expected by ProCares internal and external
- Coordinate and follow up on pharmacy network fax/email blasts as
- Responsible for monthly import reports and weekly cascading of data through various
QUALIFICATIONS AND REQUIREMENTS
- Must be a strong team player who can adapt to a team environment and work independently in a fast-paced
- Must be able to work in multiple computer systems simultaneously on a daily
- Excellent telephone etiquette and verbal/written communication
- Must be highly organized motivated take initiative and possess a willingness to learn new
- Extreme attention to detail
- Working knowledge of computers and related software applications such as Word Excel Adobe and Outlook a
- Must be able to review contracts and learn the differences of each
EDUCATION AND EXPERIENCE
Associates Degree with two years of experience in a health care setting working with contracts and/or provider relations preferred. PBM experience a plus.
PHYSICAN DEMANDS
Requires sitting standing and occasional light lifting.
Please notewhile this job description is a comprehensive overview additional responsibilities may be part of the role.
ProCare Rx will never ask for a financial commitment from an applicant as part of our recruitment process. All interviews are conducted in-person OR through video conference invitations from official company emails. For inquiries please email us at
ProCare Rx is an Equal Opportunity Employer.
Required Experience:
Unclear Seniority