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Pharmacy Network Provider Relations Manager

1 hour, 51 minutes ago
United States
Full-time
Senior
Account Manager
Sales and Business Development
Apply Now
SmithRx

SmithRx

SmithRx revolutionizes pharmacy benefits with transparent technology, connecting stakeholders for efficient drug delivery and cost savings.

Pharmaceuticals
1K-5K
Founded 2016
$38M raised
View All Jobs 20

Description

  • Identify and recruit pharmacies to join the network through market research and contract negotiation.
  • Onboard new pharmacies by screening incoming applications and supporting the credentialing process.
  • Support contract management with pharmacy providers, including reviewing performance metrics.
  • Build and maintain strong relationships with pharmacy partners and address their concerns or issues.
  • Resolve conflicts and investigate complaints by conducting root cause analysis and coordinating solutions with internal teams and providers.
  • Collaborate with cross-functional teams, including claims processing, to improve network efficiency, quality, and provider satisfaction.
  • Create standard operating procedure documentation for the Pharmacy Network.
  • Recommend process improvements for departmental workflows.
  • Build and maintain an accurate, up-to-date database of pharmacy partners.
  • Escalate pharmacy concerns internally and help resolve complex issues.
  • Assist with building and maintaining a Knowledge Base and other process improvement efforts.

Requirements

  • Bachelor’s degree or 8+ years of relevant work experience in managed care, pharmacy benefit management (PBM), or a similar healthcare setting.
  • Experience in credentialing providers, provider relations, provider administration, or pharmacy adjudication platforms is highly desirable.
  • Familiarity with pharmacy pricing, pharmacy networks and affiliations, and pharmacy-related regulations and compliance requirements.
  • Proficiency with computer software, especially MS Excel, including formulas, macros, pivot tables, and other functions.
  • Strong networking, interpersonal, and relationship-building skills.
  • Excellent verbal and written communication skills.
  • Ability to analyze data, identify trends or patterns, and draw meaningful insights.
  • Strong organizational skills, attention to detail, and the ability to manage multiple priorities in a fast-paced environment.
  • Ability to identify and resolve complex issues, escalate concerns when necessary, and recommend solutions or process improvements.
  • Pharmacy Technician Certification preferred; healthcare experience required.
  • Self-driven and motivated with a desire to succeed in a fast-paced, changing environment.

Benefits

  • Highly competitive medical, pharmacy, dental, vision, life, and AD&D insurance.
  • Flexible Spending Benefits.
  • 401(k) Retirement Savings Program.
  • Short-term and long-term disability coverage.
  • Discretionary paid time off and paid company holidays.
  • Wellness benefits and an Employee Assistance Program (EAP).
  • Commuter benefits, paid parental leave, and a well-stocked office kitchen.
  • Professional development and training opportunities.

Interested in this position?

Apply directly on the company website

Apply Now

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