Pharmacy Credentialing & Enrollment Specialist (Payer Networks)

📋 Description

• Play a key role in the assessment and fulfillment of clinical and operational reporting
• Participate in the preparation and submission of applications related to specialty network access
• Conduct primary and secondary research in support of the contracting process; with a focus on payor
• Perform investigative research into pharmacy network access at the BIN/PCN/Group level; inclusive
• Support workstreams related to state licensing matters, including new applications, credentialing
• Independently manage numerous workstreams related to contracting and payor access

🎯 Requirements

• Experience with pharmacy claims, pharmacy benefit plans (BIN/PCN/Group), specialty medications, and
• Ability to communicate results in a clear and concise manner via Excel tables, email communication
• Exceptionally organized and data driven
• Comfortable and successful handling numerous concurrent work streams
• Preferred: Project management and/or healthcare contracting experience; clinical, pharmacy, 340B