- Competitive Salary: $20/hr
- 401(k) with company match
- Medical, Dental and Health Insurance
- Telemedicine
- Paid Time Off
- Pet Insurance
- Culture that appreciates the work you do and the ideas you have
- Colleagues that share your customer focus and commitment to excellence
- Enter and maintain all pharmacy/pharmacist contacts in the company CRM software.
- Conduct outreach to engage new pharmacies/pharmacists and develop existing network relationships.
- Gather, review, and submit credential applications for network development and payor management.
- Negotiate and process single case agreements within the pharmacy network.
- Complete onboarding tasks for new network pharmacies/pharmacists and managed care payor contracts, including securing agreements, configuring EHR, and providing initial training.
- Educate and guide payors to ensure accurate loading of network contracts and providers.
- Create and maintain policies, procedures, and orientation materials related to network workflow.
- Serve as the primary contact for inquiries and concerns from internal stakeholders and external pharmacies/pharmacists.
- Investigate and communicate provider/payor changes and act as a liaison to resolve provider, claims, and contractual issues.
- Prepare and submit requests for contract changes, provider demographic data updates, and claims processing under leadership direction.
- Detail-oriented with extreme attention to detail
- Ability to manage multiple competing priorities effectively
- Strong verbal, written, and presentation communication skills
- Proven ability to work in a fast-paced environment
- Demonstrated ability to coordinate cross-functional teams and work collaboratively
- Capacity to set priorities, track project status, and meet strict deadlines
- Flexibility and adaptability in changing directions easily
- Ability to operate office equipment and utilize various software applications to support operational processes
- Bachelor's Degree preferred
- Minimum of 2 years in Provider Relations or as a Pharmacy Technician
- Proficiency with CRM systems (e.g., HubSpot, Salesforce, Zoho)
- Strong working knowledge of Microsoft Office programs (MS Excel, PowerPoint, Word, etc.)
- Willingness to travel as required, up to 25%
-
SF nCino Developer
3 weeks ago
Cognizant Buffalo, United States Full timeWhat makes Cognizant unique? · Our strength is our people, and our ability to work together. We pride ourselves on the talent we are able to attract to our organization.We not only hire the best, but continuously strive to provide our associates with opportunities to work with in ...
-
Network Systems Specialist I
3 weeks ago
Roswell Park Comprehensive Cancer Center Buffalo, United States Full timeSummary: · Wireless Engineer with expertise in Juniper Mist and Konnectio RTLS technologies to join our dynamic IT team. In this role, you will play a critical role in designing, implementing, and optimizing wireless network solutions, with a primary focus on Juniper Mist and K ...
-
Data Manager I
3 weeks ago
Roswell Park Comprehensive Cancer Center Buffalo, United States Full timeSummary: · Provides clinical data services for a data network operation, fulfilling requests in a timely manner; acts as a certified honest broker; abstracts data from the medical record or other institutional sources and accurately enters into a data collection system; provide ...
-
Locum Physician
6 days ago
LocumJobsOnline Buffalo, United States Full timeLocumJobsOnline is working with Barton Associates to find a qualified Pediatrics MD in New York · About The Position · Cross New York off your bucket list with this locum tenens opportunity Our client is looking for a physician specializing in pediatrics to begin coverage immedia ...
-
Cybersecurity DLP Engineer
3 weeks ago
M&T Bank Buffalo, United States Full timeOverview: · An ideal Data Loss Prevention Engineer will design detailed data protection solutions and present as a Subject Matter Expert (SME) on various industry Data Loss Prevention tool sets. The candidate will provide highly technical and detailed data analysis in efforts to ...
-
TPA Claims Specialist II
1 week ago
USI Insurance Services Buffalo, United StatesGeneral Description: · Adjuster of lost and non lost time claims for workers compensation. Responsibilities: · Advanced Knowledge of claims function and processes. · Ability to effectively communicate with internal and external customers. · Strong understanding of workers comp ...
-
mgr - warehouse ops, usc
1 week ago
Rich Products Corporation Buffalo, United StatesLocation: Buffalo, NY, US, 14213 · #job- { display: inline; } Req ID: 35160 Segment: Supply Chain .buttontext6b123dc6bc5e368e a{ border: 1px solid transparent; } .buttontext6b123dc6bc5e368e a:focus{ border: 1px dashed #d31145 important; outline: none important; } Rich's, also ...
-
University at Buffalo Buffalo, United States Full timePosition Summary · The Audiovisual Systems Programmer plays a pivotal role in designing, implementing, and maintaining audiovisual systems, immersive content environments, and control solutions to enhance teaching and learning and collaboration experiences across our campus. T ...
-
Network Systems Specialist II
2 weeks ago
Roswell Park Comprehensive Cancer Center Buffalo, United States Full timeSummary: · •Provides a full range of technical services for any of the following technologies within the infrastructure realm which include the Servers, Microsoft SCCM And Intune; provides services including the setup, system configuration, implementation and security within th ...
-
Lead Auditor
3 weeks ago
Wilmington Trust Buffalo, United States Full timeOverview: · This position is responsible for executing internal audit examinations over the Bank's Information Technology (IT) Engineering, Operations, Governance, Risk Management, and Architecture functions ensuring the timely and professional execution of the examinations in a ...
-
Executive Director
6 days ago
New York Civic Engagement Table Buffalo, United StatesNew York Civic Engagement Table (NYCET) Mission · The New York Civic Engagement Table (NYCET) builds power with communities of color, immigrants, poor and working people to tackle racial and economic inequality in New York. Collaborating with a diverse group of social justice and ...
-
Technology Controls Program Manager
1 week ago
HSBC Buffalo, United States Permanent - temps pleinOur purpose – Opening up a world of opportunity – explains why we exist. Here at HSBC we use our unique expertise, capabilities, breadth and perspectives to open up new kinds of opportunity for our more than 40 million customers. We're bringing together the people, ideas and capi ...
-
PBM Contract Manager
1 week ago
Independent Health Buffalo, United States Full timeFIND YOUR FUTURE · We're excited about the potential people bring to our organization. You can grow your career here while enjoying first-class perks, benefits and commitment to diversity and inclusion. · Overview · The PBM Contract Manager will be responsible for the oversight a ...
-
Floor Care Technician
2 weeks ago
ServiceMaster Clean Buffalo, United States Full timeFor more than 60 years, ServiceMaster Clean has been creating cleaner, healthier, safer work environments for our customers. As a ServiceMaster Service Partner, you belong to a team that works together to deliver the best solutions and customer service to our clients. Our essent ...
-
Head of Platform
6 days ago
43North Buffalo, United StatesWHY US · Working for 43North is an experience like no other. Each year, we invest $5 million in startup companies that relocate to Buffalo through our startup competition. We are on a mission to boost Buffalo's startup ecosphere by helping our founders and their teams thrive. We ...
-
Operations Manager Credit Services
4 days ago
HSBC Buffalo, United States Permanent - temps pleinOur purpose – Opening up a world of opportunity – explains why we exist. Here at HSBC we use our unique expertise, capabilities, breadth and perspectives to open up new kinds of opportunity for our more than 40 million customers. We're bringing together the people, ideas and capi ...
-
Assistant Manager
2 weeks ago
Windsor Fashions Buffalo, United States Full time/Part timeJob Details · The Windsor Story: · Beauty is eternal. It is captured in the way you feel and in the way you look. It is timeless. Every generation needs to feel beautiful. Some things don't change. Some things should not change. · Helping women feel beautiful has been our missi ...
-
Technology Support Specialist
1 week ago
edgecomputingassociation Buffalo, United StatesLocation Buffalo, New York , · United States · Job Description · Description · TITLE: CISCO PRE-SALES TECHNOLOGY SUPPORT SPECIALIST (SOLUTION ARCHITECT) · DESCRIPTION: · Our company, Ingram Micro, touches 80% of the technology you use every day with our focus on Technology ...
-
Senior Network Engineer ISE
4 days ago
M&T Bank Buffalo, United StatesThis role offers a hybrid work schedule; offering the flexibility to work from home two days a week, while providing the opportunity for in-person collaboration. · Overview: · This Engineer would be responsible for engineering, implementing, troubleshooting, and maintaining the ...
-
Network Engineer
1 week ago
Debellis Catherine Morreale Buffalo, United StatesWith a footprint in the Buffalo legal market for over 200 years, you'll join a longstanding legal team that continues to expand in the WNY area as well as other markets. · You'll use your Network Engineering experience to manage physical and virtual Windows servers along with Ci ...
Pharmacy Network Associate - Buffalo, United States - Clarest Health
Description
Job Description
Job DescriptionJoin CSS Health (a division of Clarest Health) where we lead the industry in innovative Medication Management and Care Coordination software. Founded by clinicians and IT professionals, we are dedicated to providing actionable data to enhance healthcare delivery and reduce costs.
We're on the lookout for a full time, Pharmacy Network Associate to join our growing team. This is a fantastic opportunity for someone that is customer centric and is looking for a remote eligible role. The states that this role is eligible for remote work in, are listed below.
Why work for us?
About the Role:
The Pharmacy Network Associate is responsible for the development (outreach, enrollment and contracting) and management (ongoing credentialing, and payment coordination) of the APN pharmacies and pharmacists. This position supports multiple internal stakeholders including account management, clinical operations, compliance, and finance as it relates to contractual obligations. This role reports to the Senior Director of Clinical Development
The Advanced Practice Network (APN) is a national network of pharmacists/pharmacies who provide clinical services, including medication therapy management (MTM), diabetes care, tobacco cessation support, and more. The purpose of the network is to develop clinical pharmacists who are engaged in clinical services and can provide those services for payers such as health plans.
Key Responsibilities:
Skills:
Qualifications:
Remote eligible for candidates residing in the following states: New York, Florida, Texas, Missouri, North Carolina, Pennsylvania, Oklahoma, Oregon, Illinois, Wyoming, California, Arkansas, West Virgina, Maine, Ohio and Georgia
Clarest is an Equal Opportunity Employer. Reasonable accommodations will be made to enable individuals with disabilities to apply for a job or to perform the essential functions of their job. Please advise us if you require a reasonable accommodation.
