Pharmacy Credentialing Specialist
4 days ago
As 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 credentialing and re-credentialing to ensure compliance with regulatory, accreditation and various managed care plan policies and protocols, standards, and requirements.
Develop and foster 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.
Maintain all pharmacy site credentialing and re-credentialing files, electronic and paper.
Effectively communicates with admission, billing, and clinical teams in a professional manner.
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.
Strongly preferred certified Provider Credentialing Specialist and college course work.
About Elevance Health
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.
What We Offer
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.
Work Environment
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.
Equal Employment Opportunity
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.
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