Affiliation Specialist

Job Description

REQUIREMENTS

• A detailed and results oriented person with 3-years administrative/clerical/customer support experience and relevant pharmacy PBM-related experience
• Possess the ability to effectively follow oral/written instructions, analyze data, apply good fact-finding skills to solve relevant and related pharmacy problems associated with services provided to clients
• Excellent written and verbal communication skills
• Experienced in MS Word and Excel
• Work in a team driven environment and be able to manage multiple priorities and projects
• Good interpersonal skills: able to work well with a wide range of people
• Strong organizational and time management skills
• Demonstrate dependability through good attendance and adherence to timelines and schedules
• Good follow through on projects and deliverables
• Good analytical skills
• Good problem-solving skills
• Demonstrate resourcefulness and ability to take initiative in development and completion of projects
• Strong sense of customer service
• Demonstrate basic computer knowledge through effective use of a personal computer including Microsoft Office applications. Computer skills to include: file management skills, Internet, Microsoft Windows, database, word processing (WORD), spreadsheets (Excel), presentation software (PowerPoint), graphics

RESPONSIBILITIES

• Identify and maintain affiliation enrollment procedures to ensure timely and accurate pharmacy affiliation to PBM contracts, central pay 835 files, as well as standalone service adds
• Manage non-central pay 835 file affiliation process to ensure timely and accurate set-up and receipt of 835 files
• Work with the reconciliation team to ensure 835 files are received in the initial set-up process in a timely manner and resolve gaps in affiliation
• Work with Management to maintain policies and procedures to ensure successful onboarding of new pharmacies to our client’s PBM agreements and non-central pay 835 file processes
• Document call and work activity in the Pharmacy Data Management System (PDMS) and review Daily Notes report to ensure follow-up and resolution
• Monitor and address issues from Affiliation Support email box
• Act as liaison between pharmacy and PBM contacts regarding direct contracts and affiliation process
• Process service level and PSAO level terminations in appropriate fashion
• Attend and actively participate in Affiliation Team Meetings
• Abide by department workflow, policies, and procedures
• Remain current on pharmacy industry trends and aware of our client’s pharmacy member business needs and concerns
• Follow defined work plans and leadership direction to meet due dates when addressing pharmacy member concerns or adverse issues
• Perform other duties and projects as required by management
• Process and submit monthly and quarterly rosters for various PBM contracts for affiliation and terminations
• Respond to customer inquiries throughout affiliation process via email and phone call
• Map and maintaining PBM Enrollment forms in Credentialing System

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