Provider Relations SpecialistMedOne Pharmacy Benefits, Dubuque, IA
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MedOne Healthcare Systems is a national, full-service transparent pharmacy benefit administrator headquartered in Dubuque, Iowa and licensed as a third-party administrator (TPA) by the State of Iowa.
We are an innovative and fast-paced company looking for employees interested in working for a business where they can make a difference. MedOne is committed to building solutions with the most current technologies available in the market place. We operate in a fast-growing industry that supports significant business growth and as a result, wonderful growth opportunities for our employees.
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
• 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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|Years of Experience||2-5 Years|