Pharmacy Network Manager
Pharmacy Network Manager
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Salary Not Disclosed
1 Vacancy
Job Description
ESSENTIAL DUTIES AND RESPONSIBLITIES include but are not limited to the following:
Responsible for day-to-day operational support for pharmacy questions via phone and/or email.
Responsible for Network Development emails; respond to requests and questions from pharmacies in a timely
manner.
Initiate and tracks contract from initial draft to full execution.
Provide written and/or verbal contractual education for pharmacies as needed.
Target and recruit additional pharmacies to meet Plan network adequacy requirements and/or requests and
maintain network relationships with small independent/chain pharmacies.
Participate in re-contracting efforts as required and directed.
Shepherd contracts through the negotiation process for independent pharmacies and small chains and maintain
relationships with those contracted entities.
Lead Hospice Contracting initiatives.
Update multiple systems with contract data and demographic information as required.
Submit pricing changes to the Quality Assurance team.
Assist in RFP responses.
Responsible for maintaining the Pharmacy Administrative Manual (PAM).
Work with the Credentialing Specialist to ensure credentialing standards are met.
Investigate pharmacy claim issues; pricing complaints and perform Pricing Escalation triage for the network
Analyst.
Communicate with the MAC/Reimbursement team as required.
Participate in the weekly GER review call and make changes in the system based on those reviews.
Attend meetings for new plan implementations.
Ensure deliverables are on time and meet quality levels as expected by ProCares internal and external customers.
Coordinate and follow up on pharmacy network fax/email blasts as required.
Responsible for oversight of monthly import reports and weekly cascading of data through various systems.
Prepare documentation for audits as requested by manager and support URAC accreditation.
QUALIFICATIONS AND REQUIREMENTS
Must be a strong team player who can adapt to a team environment and work independently in a fast-paced
environment.
Must be able to work in multiple computer systems simultaneously on a daily basis.
Excellent telephone etiquette and verbal/written communication skills.
Must be highly organized motivated take initiative and possess a willingness to learn new processes.
Extreme attention to detail required.
Working knowledge of computers and related software applications such as Word Excel Adobe and Outlook a
must.
Must be able to review contracts and learn the differences of each contract.
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:
Manager
Employment Type
Full-Time
