Pharmacy Contract Coordinator ( Remote )

Company: Amber Specialty Pharmacy
Location: Omaha
Posted on: May 28, 2023

Job Description:

The range of pay is between $45K-$54K based on experience. The Corporate Pharmacy Contract Coordinator is responsible for insight and knowledge of enrollment and credentialing requirements, audit processes, and other rules and regulations of third-party payors, including government payors, to support growth and financial durability. The Coordinator will actively promote collaboration across system-wide stakeholders to secure favorable outcomes/solutions with payors that fit the needs of our patients and our organization. In addition, their contributions will be deeply valued for their working knowledge of Pharmacy Operations, Provider Relations and Payor Relations including commercial payor and government payor eligibility rules, benefits, product design, billing and claims. Primary Responsibilities: Review and manage Pharmacy Benefit Manager (PBM), Commercial Health Plan, Home Infusion Therapy, Medical, Managed Care and other payer contracts; including drafting, evaluation, negotiation, execution, credentialing, and revalidation. Maintain and improve the company's contract database by accurately indexing, categorizing, and storing documents. Manage the contract workflow to ensure updates, maintenance and/or credential or renew credentialed contracts for accuracy and representation of the payer's expectations. Develop and maintain appropriate contract schedules, files, documentation and tracking mechanisms and provide periodic reports to management and affected department on the current status of contracts under review. Prepare initial drafts of agreements based on internal/external requests. Manage the contract process from intake of request to execution and distribution/maintenance of finalized agreements, including drafting memos summarizing the contracts for executive review. Distribute newly executed agreements at an organizational level providing a summary of the contents of the agreement. Work with Manager, Business Development to ensure contract close-out, extensions and renewals. Initiates and executes letters of agreement for patient-specific, payer-specific, or product-specific requests. Resolve issues as they arise throughout the life cycle of the contract. Support efforts to ensure that all applicable agreements with clients and vendors remain current. Assist with implementation of contract management principles throughout the organization. Coordinate with various operations teams to determine whether the Company can accommodate operational changes when such changes are requested during the course of contract negotiation. Work with team to ensure applications and periodic reports going to payers are reviewed for quality and accuracy. Provide exceptional and timely customer service to our partners on all contracting and payer access matters. Identify and escalate non-standard, complex matters to appropriate internal resources. Assist in various projects and other duties assigned by manager. Qualifications: Bachelor's Degree or equivalent work experience required. Paralegal certification preferred. Working knowledge of the healthcare industry, pharmacy and PBM business environment a plus. Excellent working knowledge of NCPDP registration and requirements Excellent working knowledge of Medicare and Medicaid requirement Excellent verbal and written communication skills. Excellent critical thinking and deductive reasoning skills. Strong computer skills and proficient in the Microsoft Software Products. Ability to work collaboratively with management, internal team members, and external personnel within various existing/potential clients and vendors. Able to acquire, handle, store, retrieve, and understand various information rapidly and efficiently. Ability to deliver projects according to plan and on time. Ability to work independently with minimal supervision. Ability to manage and direct multiple projects concurrently. Benefits: Paid Parental Leave 401(K)-vesting and company match Paid Time Off Benefits Paid Holidays Casual Dress Training and Development for Career Growth Employment Type: Full Time Bonus/Commission: No

Keywords: Amber Specialty Pharmacy, Omaha , Pharmacy Contract Coordinator ( Remote ), Healthcare , Omaha, Nebraska