Pharmacy Contract Coordinator ( Remote )
Company: Amber Specialty Pharmacy
Location: Omaha
Posted on: May 28, 2023
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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
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