Posted in General Business 30+ days ago.
Type: Full-Time
Location: Rancho Cordova, California
Serves as the departmental resource for assigned credentialing and contracting projects. Projects range from basic to moderate complexity. Using advanced systems knowledge and provider credentialing/contracting information, identifies barriers impacting on meeting credentialing and contracting requirements, develops strategies for resolution and facilitates implementation of a solution. Serves as liaison for external and internal customers of the Credentialing/Contracting Administration and payment center information.
Responsibilities
1-3 years of experience in data management, credentialing, claims, insurance administration or health care setting or on the job equivalent required.
Analysis and problem solving skills required.
Ability to interface with multi-disciplinary high level professionals.
Ability to identify barriers and elevate issues.
Strong interpersonal and communication skills, both written and verbal.
Ability to establish strong relationships and influence work performance of others.
Intermediate MS Excel and strong skills in other MS Office products., Bachelors degree preferred.
Pharmacy Benefits Management (PBM), managed care or behavioral health experience preferred.
Experience utilizing quality improvement methodologies preferred.
General Job Information
Title
Pharmacy Network Administrator
Grade
20
Work Experience - Required
Claims, Healthcare
Work Experience - Preferred
Education - Required
GED, High School
Education - Preferred
Bachelors
License and Certifications - Required
License and Certifications - Preferred
Magellan Health, Inc. is proud to be an Equal Opportunity Employer and a Tobacco-free workplace. EOE/M/F/Vet/Disabled.
Every employee must understand, comply with and attest to the security responsibilities and security controls unique to their
position; and comply with all applicable legal, regulatory, and contractual requirements and internal policies and procedures.
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