Pharmacy Credentialing & Enrollment Specialist (Payer Networks)
Shields Health Solutions
WorldwideFully remoteFull TimeMid LevelHealthcare & Telemedicine
Posted 5 hours ago5h agoApply link checked 3 hours ago
Why we think you can apply
- Hiring model
- Open worldwide · the employer states no country restriction
- Work from
- Anywhere, the UAE included
Posted 5 hours ago · apply link checked 3 hours ago
About the role
Responsibilities
- Support assessment and fulfillment of clinical and operational reporting required by payor and PBM networks
- Prepare and submit applications for specialty network access on behalf of partners
- Conduct primary and secondary research on payor access and specialty formularies
- Perform investigative research into pharmacy network access at BIN/PCN/Group level, including test claims
- Support state licensing workstreams, including new applications, credentialing and re-credentialing
- Independently manage numerous contracting and payor access workstreams
- Provide timely customer service to partners on contracting and payor access matters
Requirements
- Experience with pharmacy claims and pharmacy benefit plans (BIN/PCN/Group)
- Knowledge of specialty medications and specialty pharmacy care models
- Ability to communicate results via Excel, email and PowerPoint
- Strong organization and data-driven approach
- Ability to handle numerous concurrent workstreams
- Solid Microsoft Office skills; data entry assessment during hiring
Preferred Qualifications
- Project management and/or healthcare contracting experience
- Clinical, pharmacy, 340B or pharmacy benefit management knowledge
About the Company
Shields Health Solutions is a healthcare services company partnering with health systems on specialty pharmacy.
What we look for
- Experience with pharmacy claims and pharmacy benefit plans (BIN/PCN/Group)
- Knowledge of specialty medications and specialty pharmacy care models
- Ability to communicate results via Excel, email and PowerPoint
- Strong organization and data-driven approach
- Ability to handle numerous concurrent workstreams
- Solid Microsoft Office skills; data entry assessment during hiring
- Project management and/or healthcare contracting experience
- Clinical, pharmacy, 340B or pharmacy benefit management knowledge
Project ManagementHealthcareExcelMicrosoft OfficePowerPointpharmacy340BPharmacy Benefit Management
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Shields Health Solutions
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NeverApply scores every new listing against your CV, salary floor and visa. A handful of real matches by morning.
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