RESPONSIBILITIES:

Advanced Operations Ownership

• Leads complex workstreams including contract intake/review tracking termination processing coordination contract research and maintenance of critical databases and files.

• Oversees quality and timeliness of network communications and materials; ensures accuracy and alignment with current program rules.

• Performs advanced invoice audit support per contract; supports A/R and A/P exception resolution where applicable.

• Leads and manages the end-to-end credentialing process to ensure data accuracy and rapid turnaround including collecting and updating licensing and insurance FWA attestation producing and delivering monthly full credentialing files to PBMs.

Escalations & Stakeholder Coordination

• Serves as the primary escalation point for provider/PBM/MCO issues that impact participation claims processing outcomes or network roster accuracy.

• Coordinates across internal teams (managed care directors account management retail sales leadership compliance operations) to drive decisions and resolution.

• Establishes clear escalation pathways and ensures documentation of decisions approvals and outcomes.

Queue Leadership & Service Management

• Oversees day-to-day workload orchestration: call/email/fax case routing priority assignment aging management and follow-through.

• Tracks recurring issues identifies root causes and partners with management to implement corrective actions (process fixes training system requests).

Training Mentoring & Standardization

• Acts as primary trainer/mentor for reps; provides structured coaching on contracts database governance PBM interactions and customer communication standards.

• Maintains and improves SOPs templates and checklists; drives consistent adoption across the team.

Data Integrity Reporting & Insights

• Performs audits and spot checks to ensure data integrity in network databases and contract files.

• Develops and provides reporting/trend insights (contact drivers defects rework rates cycle time escalation themes) to management; recommends process enhancements.

Continuous Improvement & Manager Support

• Supports leadership objectives related to customer experience retention and process efficiency by:

  • Implementing best practices for membership/network accuracy

  • Reducing avoidable escalations and rework

  • Improving turnaround times for provider-impacting requests

  • Assists with drafting internal/external communications (as delegated) and ensuring message accuracy and compliance.

EXPERIENCE AND EDUCATIONAL REQUIREMENTS:

• Able to understand market trends that effect pharmacy business.

• Ability to work independently with minimal supervision; self starter.

• Strong analytical skills and attention to detail.

• Ability to convey results of analysis and resolve problems in a logical organized fashion.

• Ability to manage multiple projects and deadlines.

• Ability to communicate effectively both orally and in writing and strong interpersonal skills.

• Possess decision making and problem solving ability.

• Proficient in Microsoft Office Excel Access Word and Power Point.

• Must be proficient in personal computers and server usage.

• Experience with relational databases and knowledge of query tools and/or statistical business intelligence software (Micro Strategy) is beneficial.

• Possess a high discipline for performing quality work and a strong focus on customer satisfaction.

What Cencora offers

We provide compensation benefits and resources that enable a highly inclusive culture and support our team members ability to live with purpose every addition to traditional offerings like medical dental and vision care we also provide a comprehensive suite of benefits that focus on the physical emotional financial and social aspects of wellness. This encompasses support for working families which may include backup dependent care adoption assistance infertility coverage family building support behavioral health solutions paid parental leave and paid caregiver leave. To encourage your personal growth we also offer a variety of training programs professional development resources and opportunities to participate in mentorship programs employee resource groups volunteer activities and much more. For details visit time