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13Nov

Provider Relations Specialist

Medone Healthcare Systems, Dubuque, IA

Essential Job Functions

• Establish and maintain contracts with pharmacy providers • Maintain and update pharmacy manual and payor sheets • Make decisions regarding the resolution of pharmacy issues • Research pricing inquiries from pharmacies • Facilitate submittal, receipt, tracking, and process flow of contracts between MedOne and providers • Accurately enter information and maintain contract database • Coordinate pharmacy network communications • Serve as the subject matter expert on the standard pharmacy services agreement language including compliance and performance measures • Develop a thorough understanding of the network structure of MedOne’s clients • Assist with MAC management • Attend industry conferences, trade shows, and meetings (e.g., NCPDP) as necessary for continuing education • Work with minimal guidance • Complete special projects as assigned • Portray the company in a positive image • Required to abide by all rules, regulations and policies of the employer

Work Hours

• Full-time position • Position may require some travel including overnight stays

Required Experience & Skills

• Well-organized, self-directed and able to work with minimal amount of supervision • Highly detail-oriented and responsive with ability to monitor inbound inquiries and respond quickly, thoroughly and accurately • Ability to multi-task, managing multiple projects/priorities daily • Excellent research, follow-up, documentation and issue-resolution skills • Ability to exercise considerable judgment, maintain confidentiality and act in a diplomatic manner • Motivated to meet and exceed expectations • Ability to communicate effectively with all levels within an organization, as well as external stakeholders • Ability to work extended hours, weekend, and holidays as needed pursuant to industry demands


Preferred Experience & Skills

• 3 – 5 years in a pharmacy benefit or health insurance environment • Contract, legal, and compliance experience


Continuing Education Requirements

• As needed for various certifications and licenses

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Job Details

Req Num --
ID 423824
Location
Dubuque, IA
Positions 1
Type
Employee
Status
Full Time
Pay --
Categories
Customer Service
Insurance
Legal
Pharmacy
Sales/Service
Benefits
Health Insurance
Dental Insurance
Vision Insurance
Life Insurance
Paid Vacation

Preferred Candidates

Years of Experience 2-5 Years
Education Associates

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