Make decisions regarding the resolution of pharmacy issues
Establish and maintain contracts with pharmacy providers
Facilitate submittal, receipt, tracking, and process flow of contracts between Navitus and providers
Accurately enter information and maintain contract database
Generate reports on network performance to monitor the claims accuracy throughout the terms of the contract
Responsible for creating networks based on the contract terms within the claims processing system and ensure accuracy with performing quality reviews
Assists in resolving intricate pharmacy provider issues and complaints
Coordinate pharmacy network communication efforts including collection of content, disseminating information to provider partners through appropriate channels, and tracking response metrics
Other duties as assigned

College or 2-year Technical Degree or equivalent experience is preferred.
Advanced technical education a plus
Certified Pharmacy Technician license preferred
1-3 years of successful experience in a customer service role
Knowledge of PBM or health care industry preferred
PC skills: Microsoft Office, Email, Internet, and other applications as required
Participate in, adhere to, and support compliance program objectives
The ability to consistently interact cooperatively and respectfully with other employees

Pharmacy Relations Specialist

Key skills