Manager, Managed Care Operations

| Remote
Sorry, this job was removed at 12:05 p.m. (EST) on Saturday, December 4, 2021
Find out who’s hiring remotely
See all Remote jobs
Apply
By clicking Apply Now you agree to share your profile information with the hiring company.

Medly is a patient-first digital pharmacy that delivers free, same-day prescription medication to patients throughout the nation. At Medly, our mission is to elevate the healthcare journey for all patients - regardless of income, lifestyle, or diagnosis.

We are seeking an experienced Manager, Managed Care Operations to manage all aspects of NCPDP, Medicare, Medicaid, and payer enrollment, maintain an up-to-date tracking of applications / enrollment forms progress, contact list, and licensing information for all pharmacies, maintain accreditation and relevant program standards for reporting and tracking as needed. The Manager, Managed Care Operations shall possess thorough and high organizational skills, exceptional level of attention to details and specifics, gathers, maintains, and distributes all necessary documentation in an organized and efficient manner.

This position can be based remotely from any U.S. location and will require occasional travel to Medly's headquarters in Brooklyn, NY.


What you’ll do:

  • Accurate completion of initial enrollment and renewal of relevant pharmacy applications for NCPDP, Medicare, Medicaid and PBM’s.
  • Updating web portals as required with pharmacy licensing and credentialing documentation.
  • Maintaining an up-to-date tracking of applications / enrollment forms progress and contact list,
  • Create databases from the financial reporting system and prescription dispensing system to support applications and ongoing credentialing; work with Director of Managed Care, pharmacy team, accounting team, inventory/finance, legal, and all applicable personnel internal and/or external to maintain and enhance third party plan information.
  • Maintain contract data base including, contracted rates, expiration dates etc.
  • In partnership with HR, compliance and compile and maintain up-to-date records for all pharmacy staff and pharmacies required for government and PBM credentialing.
  • Evaluate and analyze the business impact of PBM and Health Plan contracts and amendments to assist in decision making regarding changes in reimbursement rates.
  • Adaptable, open to change, and able to work in ambiguous situations and respond to new information or unexpected circumstances.
  • Other tasks and projects as needed.


What you'll need:

  • Bachelor’s degree in health science or related fields; or an equivalent combination of education and experience.
  • Two (2) years managed care experience or equivalent from a pharmacy provider or payer level.
  • One (1) year experience in contract review or equivalent from a pharmacy provider or payer level.
  • Demonstrated strong PC skills including proficiency with the primary Microsoft Office applications.


Medly Pharmacy is an equal opportunity employer. We proudly celebrate diversity and are devoted to creating an inclusive environment for all employees regardless of race, color, religion, national origin, sex, sexual orientation, age, disability, military service, or any other non-merit factor.

Read Full Job Description
Apply Now
By clicking Apply Now you agree to share your profile information with the hiring company.

Location

Our HQ in Brooklyn is unique - on the bottom floor is our pharmacy, and top two are where corporate sits. We're also right by an awesome food scene!

Similar Jobs

Apply Now
By clicking Apply Now you agree to share your profile information with the hiring company.
Learn more about MedlyFind similar jobs