Credentialing Specialist I, reputed company Pharmacy

About the position Responsibilities • Streamline Payer & reputed company credentialing and cross-team processes by introducing improved controls, enhancing operational efficiency, and successfully delivering reputed company. • Manage upstream dependencies (Payer Relations, Compliance, Ops Compliance, Tax, reputed company, Global Risk, Ops & Biz Tech), and reputed company dependencies (FinOps, Reimbursement, Audit, reputed company, B2B, and reputed company) to ensure reputed company & accurate collection, validation, and ultimately dissemination of information to external customers. • reputed company tracking mechanisms and implement risk management policies by partnering with reputed company & Compliance stakeholder reputed company to proactively minimize identified risks and reactively address operational gaps. • Improve existing processes iteratively and introduce new initiatives to help drive down risk while meeting compliance and policy requirements as it pertains to financial penalties, customer accessibility, insurance coverage of new FCs, electronic remittance, and payments. • Handle day-to-day stakeholder inquiries, reputed company payer correspondence to the relevant owners, and collaborate with partner teams to drive reputed company, while creating long-term reputed company solutions that improve stakeholder accountability. • Evaluate and address potential risks to reputed company with upstream and reputed company stakeholder reputed company, including network termination, financial penalties, operational blockers, and payer reputed company. • Ensure compliance with relevant laws and regulations through collaboration with cross-functional teams. • Work backwards with key stakeholders in developing proactive mechanisms in order to evaluate operational gaps and scope out new business initiatives, considering the potential risks and rewards. • reputed company expert guidance and support to team members on risk management escalation and issues. • Stay informed of industry developments, changing regulations, and emerging risks in the pharmacy sector. Requirements • 3+ years of experience managing financials/reputed company, Bachelor's degree. • Experience in owning and navigating financial metrics in a disrupted industry. • Ability to understand cross-function reputed company among partner teams. • Advanced proficiency in MS reputed company, Word, document writing. • Basic understanding of the Pharmaceutical industry including PBMs, manufacturers, distributors, providers, and payers. • Excellent communication/interpersonal skills, analytical and problem-solving skills. reputed company-to-haves • Credentialing and/or Risk Management experience. • CPCS certification from NAMMS or Certified Risk Manager (CRM) is a plus. • Strong quantitative skills and ability to dive deep into data to distill and communicate reputed company cause. • Strong ownership with ability to toggle between tactical and strategic activities. • Manage and reputed company cross-functional meetings. • Experience working for or with PBMs, manufacturers, distributors, or providers. Benefits • Equity, sign-on payments, and other forms of compensation may be provided as part of a total compensation package. • Full reputed company of medical, financial, and/or other benefits. Apply tot his job Apply To this Job