Research and resolve pharmacy contract related inquires; evaluate network participation and distribute pharmacy contract documents; coordinate timely, accurate and complete submission of contract deliverables, and the electronic and physical tracking, storage and distribution of contract documents
Ensure all contractual obligations adhere with company policies, regulatory compliance and legal requirements; engage with Legal and Network Management leadership as needed to ensure the language provided is accurate and concise
Establish, develop, and maintain relationships with independent pharmacy providers
Manage legal-to-legal correspondences between Prime and independent Pharmacy Providers escalating to Prime Legal Counsel as required
Conduct root cause analysis, including but not limited to, investigating, monitoring, resolving and reporting for pharmacy contract and pricing analysis complaints issues
Evaluate pharmacy inquiries to include but not limited to complaints, issues and/or grievances and collaborate with internal stakeholders, such as Network Management, Client Engagement, and Benefit Operation
Manage and edit Prime’s Provider Manual to ensure compliance and timely distribution, while contributing to process improvements that support cross-functional projects, regulatory changes, and client implementations

Bachelor's degree in Business or related area of study, or equivalent combination of education and/or relevant work experience; High school diploma or GED required
5 years of work experience in a call center, customer service, operations, retail pharmacy, pharmacy technician, Pharmacy Benefit Management (PBM)
Must be eligible to work in the United States without the need for work visa or residency sponsorship
Strong interpersonal communication skills including conflict resolution and listening
Advanced ability to problem solve and interpret complex data
Proficiency within Microsoft applications such as Outlook, Word and Excel
Enhanced ability to coordinate multiple tasks and projects simultaneously under strict timelines
Ability to work in fast-paced, collaborative team environment
Enhanced ability to establish rapport and effectively influence at all levels within an organization

Senior Pharmacy Network Contract Analyst

Key skills