Exemption Status:

United States of America (Exempt)

$60,987 - $80,808 - $100,628

“Pay scale information is not necessarily reflective of actual compensation that may be earned, nor a promise of any specific pay for any selected candidate or employee, which is always dependent on actual experience, education, qualifications, and other factors.  A full review of our comprehensive pay and benefits will be discussed at the offer stage with the selected candidate.”

This position is not eligible for Sponsorship.

MedImpact Healthcare Systems, Inc. is looking for extraordinary people to join our team!

Why join MedImpact? Because our success is dependent on you; innovative professionals with top notch skills who thrive on opportunity, high performance, and teamwork. We look for individuals who want to work on a team that cares about making a difference in the value of healthcare.

At MedImpact, we deliver leading edge pharmaceutical and technology related solutions that dramatically improve the value of health care. We provide superior outcomes to those we serve through innovative products, systems, and services that provide transparency and promote choice in decision making. Our vision is to set the standard in providing solutions that optimize satisfaction, service, cost, and quality in the healthcare industry. We are the premier Pharmacy Benefits Management solution!

Job Description

Summary

*The ideal candidate will be Bilingual English/Spanish and based in Puerto Rico*

The Provider Relations Contract Analyst Puerto Rico is responsible for relationship management with pharmacies in support of plan sponsors, strategic initiatives and operational projects, pharmacy network contracting efforts and processes, and pharmacy network operations.

Essential Duties and Responsibilities include the following. Other duties may be assigned.

• Regularly visit Puerto Rico pharmacies to forge a connection and build trust
• Work with pharmacies to provide education and support on pricing, credentialing, recredentialing, attestations, and any other network related activities
• Assist Account Management in client plan benefit and network preparation with area pharmacies
• Prepare, schedule, and present at quarterly pharmacy meetings 
• Review pharmacy contract setup to ensure compliance with pharmacy network agreements
• Support pharmacy audits and network compliance initiatives
• Support daily credentialing, re-credentialing, and contracting operations
• Implement changes to ensure compliance with all company policies and procedures as well as regulatory requirements  
• Research and problem solve to resolve claim issues and concerns
• Respond to and track requests, inquiries, and communications with network pharmacies
• Collaborate with cross-functional teams on pharmacy-related matters
• Develop, review and distribute pharmacy communications to meet internal and client requests
• Investigate specific issues related to regulatory requirements through literature or internet resources
• Resolve dissatisfaction among providers within limits of authority
• Maintain current provider data to ensure the quality of the network
• Run reports and support data analysis to produce meaningful and actionable results to answer key business questions
• Monitor, track, and report pharmacy compliance with guiding government regulations and internal policies and procedures
• Track project tasks and deliverables to ensure timelines are met
• Collaborate with Implementation Managers on specific project assignments.
• Other duties may be assigned.

Client Responsibilities

This is an internal and external client facing position that requires excellent customer service skills and interpersonal communication skills (listening/verbal/written).  One must be able to; manage difficult or emotional client situations; Respond promptly to client needs; Solicit client feedback to improve service; Respond to requests for service and assistance from clients; Meet commitments to clients.

Qualifications

To perform this job successfully, an individual must be able to perform each essential duty satisfactorily. The requirements listed below are representative of the knowledge, skill, and/or ability required. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.

Education and/or Experience

BS/BA and 3+ years’ experience or equivalent combination of education and experience

Computer Skills

To perform this job successfully, an individual should have k