Current jobs related to Pharmacy Credentialing Analyst- BioPlus Specialty Pharmacy - Altamonte Springs - Elevance Health

  • Pharmacy Customer Associate

    4 days ago

    Altamonte Springs, United States Elevance Health Full time

    Anticipated End Date:2025-01-24Position Title:Pharmacy Customer Associate - BioPlus Specialty PharmacyJob Description:Be Part of an Extraordinary Team BioPlus Specialty Pharmacy is now part of CarelonRx (formerly IngenioRx), and a proud member of the Elevance Health family of companies. Together, CarelonRx and BioPlus offer consumers and providers an...

  • Pharmacy Customer Associate

    3 days ago

    Altamonte Springs, United States Elevance Health Full time

    Anticipated End Date: 2025-01-24 Position Title: Pharmacy Customer Associate - BioPlus Specialty Pharmacy Job Description: Be Part of an Extraordinary Team BioPlus Specialty Pharmacy is now part of CarelonRx (formerly IngenioRx), and a proud member of the Elevance Health family of companies. Together, CarelonRx and BioPlus offer consumers and providers an...

  • Account Service Manager

    3 weeks ago

    Altamonte Springs, United States Elevance Health Full time

    Be Part of an Extraordinary Team BioPlus Specialty Pharmacy is now part of CarelonRx (formerly IngenioRx), and a proud member of the Elevance Health family of companies. Together, CarelonRx and BioPlus offer consumers and providers an unparalleled level of service that’s easy and focused on whole health. Through our distinct clinical expertise, digital...

  • Account Service Manager

    3 weeks ago

    Altamonte Springs, United States Elevance Health Full time

    Be Part of an Extraordinary Team BioPlus Specialty Pharmacy is now part of CarelonRx (formerly IngenioRx), and a proud member of the Elevance Health family of companies. Together, CarelonRx and BioPlus offer consumers and providers an unparalleled level of service that’s easy and focused on whole health. Through our distinct clinical expertise, digital...

  • Pharmacy Credentialing Specialist

    4 weeks ago

    Altamonte Springs, Florida, United States Elevance Health Full time

    About the Role:The Pharmacy Credentialing Analyst will be responsible for accurate and prompt credentialing for health plans and pharmacy benefit managers (PBM) for all pharmacy sites. This role will also involve managing and maintaining pharmacy license tracking tool to advise pharmacy sites and pharmacists of license renewals.Key Responsibilities:Acts as a...

  • Account Service Manager

    3 weeks ago

    Altamonte Springs, United States Elevance Health Full time

    Anticipated End Date:2025-01-01Position Title:Account Service Manager - Payor Contracting- BioPlus Specialty PharmacyJob Description:Be Part of an Extraordinary TeamBioPlus Specialty Pharmacy is now part of CarelonRx (formerly IngenioRx), and a proud member of the Elevance Health family of companies. Together, CarelonRx and BioPlus offer consumers and...

  • Pharmacy Credentialing Specialist

    4 weeks ago

    Altamonte Springs, Florida, United States Elevance Health Full time

    Job SummaryAs a Pharmacy Credentialing Analyst at Elevance Health, you will play a vital role in ensuring the accuracy and timeliness of pharmacy credentialing for health plans and pharmacy benefit managers (PBM).Key Responsibilities Manage and maintain pharmacy license tracking tool to advise pharmacy sites and pharmacists of license renewals. Administer...

  • Pharmacist - BioPlus Specialty Pharmacy

    3 weeks ago

    Altamonte Springs, United States Elevance Health, Inc. Full time

    Primary duties may include, but are not limited to:Maintains established procedures concerning quality assurance, security and inventory of controlled substances, and disposal of drugs designated as hazardous waste. Receives and reviews prescriptions Pharmacy, Pharmacist, Healthcare, Experience

  • Compounding Pharmacy Technician Position Open

    4 weeks ago

    Dripping Springs, Texas, United States Matrix Pharmacy Group Full time

    About the Role:We are seeking a skilled Compounding Pharmacy Technician to join our team at Matrix Pharmacy Group. As a Compounding Pharmacy Technician, you will play a crucial role in preparing medications and ensuring the highest quality standards are met.Key Responsibilities:Weigh ingredients correctly and process them following the provided formula...

  • Pharmacy Buyer Tech III

    3 weeks ago

    Altamonte Springs, United States AdventHealth Central Florida Full time

    All the benefits and perks you need for you and your family: · Benefits from Day One · Paid Days Off from Day One · Debt-free Education* (Certifications and Degrees without out-of-pocket tuition expense) $2,500.00 Sign on (1-year commitment) Our promise to you: Joining AdventHealth is about being part of something bigger. It’s about belonging to a...

  • Pharmacy Assistant

    4 weeks ago

    Altamonte Springs, Florida, United States Revelation Pharma Full time

    Job Summary:Revelation Pharma is seeking a skilled Pharmacy Technician to join our team. As a Pharmacy Technician, you will play a vital role in ensuring the smooth operation of our pharmacy.Key Responsibilities:Compounding sterile and non-sterile pharmaceutical preparations under the supervision of the compounding pharmacist.Performing data entry and...

  • Pharmacy Operations Manager

    1 week ago

    Altamonte Springs, United States BrightSpring Health Services Full time

    Works with Pharmacy Director to implement work flow and productivity measures that will achieve performance targets and customer expectations. Works with Pharmacy Director and pharmacy staff to execute Company Initiatives, Core Processes and Quality Operations Manager, Pharmacy, Operations, Manager, Manufacturing, Healthcare, Director

  • Pharmacy Externship Opportunity

    4 weeks ago

    Altamonte Springs, Florida, United States PharMerica Full time

    Pharmacy Externship OpportunityAt PharMerica, we offer a unique pharmacy externship program that combines hands-on learning with real-world experience. As a pharmacy extern, you will work under the direct supervision of a registered pharmacist, filling prescriptions and preparing IVs. You will also assist with data entry, inventory management, and...

  • Pharmacy Technician II

    4 weeks ago

    Altamonte Springs, Florida, United States AdventHealth Full time

    About the Role:As a Pharmacy Technician II at AdventHealth, you will play a vital role in providing exceptional patient care and supporting our pharmacy team. Your primary responsibility will be to assist pharmacists with medication preparation and dispensing, while also maintaining accurate inventory management and regulatory compliance.Key...

  • Pharmacy Prior Authorization Specialist

    4 weeks ago

    Altamonte Springs, Florida, United States AtWork Group Full time

    We are seeking a skilled Pharmacy Prior Authorization Specialist to join our team at AtWork Group. This exciting opportunity will allow you to work with a fortune 500 company and be a part of a new area of growth in the pharmacy industry.The Pharmacy Prior Authorization Specialist responsibilities include:Pharmacy Prior Authorization experiencePharmacy...

  • Pharmacy Order Entry Specialist

    4 weeks ago

    Altamonte Springs, Florida, United States BrightSpring Health Services Full time

    Pharmacy Order Entry Technician Job DescriptionAt BrightSpring Health Services, we are seeking a skilled Pharmacy Order Entry Technician to join our team. As a Pharmacy Order Entry Technician, you will play a critical role in ensuring the accuracy and efficiency of our pharmacy operations.Key Responsibilities:Triage, interpret, and input orders into our...

  • Pharmacy Technician

    4 weeks ago

    Altamonte Springs, Florida, United States AtWork - Orlando North Full time

    About the Pharmacy Technician RoleWe are seeking a skilled Pharmacy Technician to join our team at AtWork - Orlando North. As a Pharmacy Technician, you will play a vital role in supporting our pharmacy operations and providing excellent patient care.Key Responsibilities:Data entry and managementPatient counseling on medicationPrior authorizations and...

  • Pharmacy Technician II Nights Position

    4 weeks ago

    Altamonte Springs, Florida, United States AdventHealth Full time

    About the Role:We are seeking a highly skilled Pharmacy Technician II to join our team at AdventHealth Altamonte Springs. As a Pharmacy Technician II, you will play a vital role in providing exceptional patient care and supporting our pharmacy operations.Key Responsibilities:Assist pharmacists with medication preparation and dispensing, ensuring accuracy and...

  • Pharmacy Instructor

    4 weeks ago

    Colorado Springs, Colorado, United States Pima Medical Institute Full time

    Teaching OpportunityIf you enjoy training and mentoring Pharmacy Technicians, this role will be very rewarding.Key Responsibilities:Design and deliver individual lesson plans in one or more subjects using various teaching techniques appealing to different learning styles.Plan instruction to achieve specific objectives based on student needs and established...

  • Auto offer Retail Pharmacy Tech

    3 weeks ago

    Glenwood Springs, United States Lancesoft INC Full time

    Job DescriptionJob DescriptionTitle: Retail Pharmacy TechShift: 40-hours/week with Saturday rotationDuration: 13 weeksRequirementsColorado Pharmacy Tech Certification, Required (DORA).2 years Retail Pharmacy experience. Flu vaccine required.Includes 1 month of free rent in Valley View studio apartment offered and then $1700/month (furnished and includes...

Pharmacy Credentialing Analyst- BioPlus Specialty Pharmacy

1 month ago

Altamonte Springs, United States Elevance Health Full time

Be Part of an Extraordinary Team

BioPlus Specialty Pharmacy is now part of CarelonRx (formerly IngenioRx), and a proud member of the Elevance Health family of companies. Together, CarelonRx and BioPlus offer consumers and providers an unparalleled level of service that’s easy and focused on whole health. Through our distinct clinical expertise, digital capabilities, and broad access to specialty medications across a wide range of conditions, we deliver an elevated experience, affordability, and personalized support throughout the consumer’s treatment journey.

Title : Pharmacy Credentialing Analyst

Location - Monday – Friday ONSITE at 380 Northlake Blvd, Altamonte Springs, FL 32701. Candidates must reside within 50 miles or 1-hour commute each way of posted office location.

Build the Possibilities. Make an Extraordinary Impact.

The Pharmacy Credentialing Analyst is responsible for accurate and prompt credentialing for health plans and pharmacy benefit managers (PBM) for all pharmacy sites.

How you will make an impact:

Primary duties may include, but are not limited to:

  • Acts as a troubleshooter in resolving payor departmental issues related to credentialing.

  • Manages and maintains pharmacy license tracking tool to advise pharmacy sites and pharmacists of license renewals.

  • Maintains confidentiality of all pertinent pharmacy and provider information.

  • Administers credentialing and re-credentialing to ensure compliance with regulatory, accreditation and various managed care plan policies and protocols, standards, and requirements.

  • Develops and fosters collaborative relationships with managed care plans, state agencies and PBM’s to facilitate timely credentialing and re-credentialing of applications.

  • Tracks credentialing and re-credentialing to ensure compliance with time sensitive materials.

  • Maintains all pharmacy site credentialing and re-credentialing files, electronic and paper.

  • Effectively communicates with admission, billing, and clinical teams in a professional manner.

  • Reviews all credentialing policies and procedures for accuracy and completeness.

  • Suggests revisions of policies and procedures when necessary.

  • Completes new Medicaid applications and renewals or revalidations.

  • Medicaid portal maintenance and updates.

  • Medicaid administrator user access for billing.

  • Pull Medicaid remits for billing team upon request if portal access is limited.

  • Manage PBM credentialing requests and maintenance.

  • Medicare (PECOS) processing for all pharmacy sites.

  • Maintain NCPDP profile for all pharmacy sites.

  • Certificate of Insurance requests and dissemination to plans or CMS.

  • NPI profile updates (NPPES). URAC, ACHC, NABP support during accreditation renewals.

  • Fraud, Waste and Abuse annual attestation submission to health plans.

  • Manage pharmacy Continuing Education Units for RFP’s. Pull and maintain credentialing documents for payor applications.

  • Knowledge of Medicaid, Medicare, Managedcare and PBM providers.

  • Additional responsibilities as assigned.

  • Submit new pharmacy license applications and renewals for all pharmacy sites.

  • Submit Pharmacist in Charge state license changes and renewals.

Minimum Requirements:

  • Requires a H.S. diploma and minimum of 3 years' experience; or any combination of education and experience, which would provide an equivalent background.

Preferred Skills, Capabilities and Experiences:

  • Strongly preferred certified Provider Credentialing Specialist and college course work.

Please be advised that Elevance Health only accepts resumes for compensation from agencies that have a signed agreement with Elevance Health. Any unsolicited resumes, including those submitted to hiring managers, are deemed to be the property of Elevance Health.

Who We Are

Elevance Health is a health company dedicated to improving lives and communities – and making healthcare simpler. We are a Fortune 25 company with a longstanding history in the healthcare industry, looking for leaders at all levels of the organization who are passionate about making an impact on our members and the communities we serve.

How We Work

At Elevance Health, we are creating a culture that is designed to advance our strategy but will also lead to personal and professional growth for our associates. Our values and behaviors are the root of our culture. They are how we achieve our strategy, power our business outcomes and drive our shared success - for our consumers, our associates, our communities and our business.

We offer a range of market-competitive total rewards that include merit increases, paid holidays, Paid Time Off, and incentive bonus programs (unless covered by a collective bargaining agreement), medical, dental, vision, short and long term disability benefits, 401(k) +match, stock purchase plan, life insurance, wellness programs and financial education resources, to name a few.

Elevance Health operates in a Hybrid Workforce Strategy. Unless specified as primarily virtual by the hiring manager, associates are required to work at an Elevance Health location at least once per week, and potentially several times per week. Specific requirements and expectations for time onsite will be discussed as part of the hiring process. Candidates must reside within 50 miles or 1-hour commute each way of a relevant Elevance Health location.

The health of our associates and communities is a top priority for Elevance Health. We require all new candidates in certain patient/member-facing roles to become vaccinated against COVID-19. If you are not vaccinated, your offer will be rescinded unless you provide an acceptable explanation. Elevance Health will also follow all relevant federal, state and local laws.

Elevance Health is an Equal Employment Opportunity employer and all qualified applicants will receive consideration for employment without regard to age, citizenship status, color, creed, disability, ethnicity, genetic information, gender (including gender identity and gender expression), marital status, national origin, race, religion, sex, sexual orientation, veteran status or any other status or condition protected by applicable federal, state, or local laws. Applicants who require accommodation to participate in the job application process may contact elevancehealthjobssupport@elevancehealth.com for assistance.