PBM Licensing
2 weeks ago
Plano Texas, United States
Maxor National Pharmacy Services, LLC
Full time
Overview:The PBM Licensing & Compliance Manager performs a wide variety of specialized operational functions for the Legal and Compliance department including pharmacy benefit management licensure, reporting, Medicaid provider enrollment, business registration, research, regulatory support, administrative support, and projects as assigned.
Location
Remote, home-based within the Continental US.
Our Company
Maxor is a leading pharmacy care solutions company dedicated to improving patient outcomes and lowering the total cost of care through our clinically integrated set of pharmacy care solutions. Our teams help optimize the pharmacy experience for patients, our customers, their employees, and members whether it’s through our customized pharmacy benefit offerings; providing access to prescription medications and therapies through our home delivery and specialty pharmacies; or delivering clinical and financial value with our end-to-end pharmacy management solutions. With a legacy of exceptional service and deep clinical and pharmacy expertise, Maxor has been a trusted partner enabling pharmacy care since 1926.
Why Maxor?
Pharmacies are essential to healthcare, with nearly 90% of the US population living within 5 miles of one and seeing their pharmacist an average of 12 times a year. Providing a positive patient experience is crucial to ensuring patients adhere to their therapies. At Maxor, we recognize that our employees are our most valuable assets. We actively seek and retain talented professionals who are mission-driven to improve healthcare outcomes for patients. And, our employees are essential to their own well-being, finding fulfillment in meaningful work, teamwork & collaboration, competitive compensation, work-life balance, diverse and inclusive teams, and limitless career possibilities. With a workforce of 1,100+ and almost a century of pharmacy experience, we offer the stability of a Fortune 500 company and the energy and innovation of a startup. Our expertise and technology support the entire pharmacy ecosystem, but our impact goes beyond pharmacy services. We enable pharmacy care.
Responsibilities:
LICENSING:
Supervises and trains Licensing Associates and Licensing Specialists
Actively participates in cross-functional planning meetings
Creates and implements the plan for licensing projects
Serves as primary support and subject matter expert for all licensure functions and processes
Develops and maintains meaningful relationships with internal stakeholders state and federal regulators
Meets all licensure and reporting deadlines
Leads PBM reporting to regulatory agencies
MEDICAID AND MEDICARE ENROLLMENT
Serves as primary support and subject matter expert for provider enrollment applications in Medicaid and Medicare
Actively participates in cross-functional pharmacy implementation meetings
BUSINESS REGISTRATION:
Serves as primary support for all business registration processes
Provides assistance to primary support in order to meet business registration deadlines
RESEARCH:
Serves as primary support for licensing-related research requests
Serves as secondary support for research on new laws and regulations impacting the PBM
PROJECTS & ADMINISTRATION:
Executes or provides assistance with projects as assigned
Maintain and update databases and tracking systems
Create and design general correspondences, memos, business information etc. Proofread copy for spelling, grammar, and layout, making appropriate changes. Responsible for accuracy and clarity of final copy.
Create, compose, and edit technical and/or administrative correspondence and documentation; screen and evaluate incoming and outgoing correspondence and prepare responses as appropriate
Prepare internal reports such as check requests, expense reports, IT requests, etc.
Enhance professional growth and development through participation in educational programs, current literature, in-service meetings, and workshops.
Maintain good inter/intra departmental relationships. Work to create an amiable atmosphere within the department and company.
Respond to change, performance improvement support, professional growth opportunities, and meet development goals.
Qualifications:
Education:
High school diploma or equivalent. College degree preferred.
Experience:
Required:
4+ years of pharmacy benefit management (PBM) licensing or equivalent experience
2+ years of experience in handling provider applications for enrollment in Medicaid or Medicare
1+ year of experience in completing and maintaining business registrations
Intermediate knowledge of Microsoft Office and Adobe products
Preferred:
Roles within legal (paralegal), regulatory, audit, and/or compliance departments
Advanced technical level skillset with Microsoft Office and Adobe Acrobat products
Knowledge, Skills, and Abilities:
Possess a strong attention to detail and consistently adhere to administrative procedures and regulatory timelines
Able to review and research state and federal regulations and determine how regulations apply from licensing and reporting perspective
Must have strong written and verbal communication skills
Effectively develop meaningful relationships with a wide range of individuals at all levels of an organization, both internal and external
Thoughtfully addresses requests for information and raise items to management as warranted
Must have a strong working knowledge of Microsoft Office (specifically, Word, Outlook, and Excel) and Adobe Acrobat
Continually seek ways to improve processes and propose changes effectively
Create, compose, and edit written materials, effectively execute tasks, and organize efficiently
Document matters as warranted and communicate and/or store information as needed
Possess knowledge and experience to make administrative and minor procedural decisions and judgments on sensitive, confidential issues with little to no direction
Gather data from internal sources, compile information, and prepare reports
Prioritize, organize and coordinate daily work timely; effectively work under pressure, and manage to competing deadlines with some direction
Develop and maintain record keeping systems and procedures
Maintain the highest level of confidentiality of company, personal, and sensitive information
Knowledge of clerical, office administrative procedures, and knowledge of use and operation of standard office equipment
WE OFFER
At Maxor, we foster a diverse and progressive culture that promotes a work-from-home model and a "dress-for-your-day" approach to work attire. Our team-oriented environment encourages collaboration and innovation.
We offer highly competitive compensation and comprehensive health benefits including:
Comprehensive mental health and wellbeing resources
Nationwide Blue Cross Blue Shield PPO with employee-friendly plan design, including a $850 individual annual medical deductible and $25 office visit copays, with low biweekly premiums
Company-paid basic life/AD&D, short-term and long-term disability insurance
Rx, dental, vision, other voluntary benefits, and FSA
Employer-matched 401k Plan
Industry-leading PTO plan
And more
Apply today at (url removed)
Maxor is an EOE, including disability/vets