Responsible for assisting the Sr. Director of Client Relations in the day to day functions of the department. This includes promoting positive relationships between Omnicare and assigned third party carriers. This position will assist in assuring contract compliance as well as budgeting / forecasting. In addition, maintenance of electronic databases, including Third Party Relativity, Epiq, and Insurance Contract Files is required.
• Function as liaison between Company and Third Party carriers on all routine contracting interactions.
• Maintain hard-copy contract files, e-contract network folders and Encore database required under CIA to support Trade Relations contract functions.
• Coordinate all third party contract activities, including initial communications/qualifications with third party representatives and monitoring/tracking all contract related activities to complete execution and filing.
• Ensure timely distribution of payor communications to Operations as required and appropriate
• Coordinate the completion of credentialing / recredentialing applications received from assigned third party carriers.
• Analyze claim data to ensure compliance with contract terms.
• Assist in preparation of department’s monthly forecasts as well as budgets.
• Process contracts as received; includes assisting in completion and submission of Contract Review and Approval Form (CRAF) requests as required by the Corporate Integrity Agreement.
• Abide by requirements of Corporate Compliance Program, including the Corporate Integrity Agreement in the performance of all duties.
Minimum (Required) Qualifications:
• Bachelor’s degree; three (3) to (5) five related experience.
• Ability to move seamlessly between administrative and analytical functions.
• Must have an intermediate knowledge in Microsoft Office software, e.g. Outlook, Excel, Word, PowerPoint and Access.
• Ability to prioritize workload and responsibilities, to accomplish goals and meet deadlines.
• Must be an effective communicator with excellent verbal and written skills
• Solid analytical, decision making, problem solving, and organizational skills.
• Must be highly focused, goal-driven, self directed and self motivated for variety of tasks and assignments.
• Must be able to exercise independent judgment within general guidelines.
• Must possess the ability to positively interact with other employees and the general public.
• Bachelor’s degree in Business or MBA, preferred.
• Previous experience in pharmacy is preferred, but not required.
• Experience in contract management.
• Knowledge of Medicaid and Third Party Insurer regulations relating to reimbursements and remittance files.
Same as above
Omnicare, Inc - 13 months ago
Omnicare strives to be omnipresent in US nursing homes. The firm is the country's largest institutional pharmacy services provider,...