Overview
AI Legal Drafting Specialist Jobs in Salt Lake City, UT at Filevine
Contract Admin Specialist – Payor Contracts JD – Feb 2025.pdf
Company Overview: BioMatrix Specialty Infusion Pharmacy is a leading provider of home infusion therapy services dedicated to improving patient outcomes and enhancing quality of life. We are committed to delivering exceptional care and support to our patients and their families. We are currently seeking a detail-oriented and experienced Contract Administration Specialist to join our payor contracting team
Job Summary: The Contract Administration Specialist for Home Infusion Payor Contracts will be responsible for managing the pharmacy application and credentialing process for Health Plan and PBM payors. This role requires a thorough understanding of payor requirements, regulatory standards, and compliance processes. The ideal candidate will have a strong background in credentialing, excellent organizational skills, and a commitment to maintaining the highest standards of quality in healthcare.
Key Responsibilities:
Credentialing Process Management:
Oversee the pharmacy application, credentialing and re-credentialing processes for Health Plan and PBM payors, ensuring compliance with the payor credentialing process and regulatory standards
Payor Contract Compliance:
Ensure that all necessary documentation and applications for payor contracts are completed accurately and submitted in a timely manner
Manage fully executed contracts and amendments utilizing ContractSafe
Data Management:
Maintain accurate and up-to-date payor files, including credentialing documentation, contracts, and correspondence
Maintain accurate and up-to-date document library of all licenses, certifications and applicable information required for payor credentialing and applications
Collaboration and Communication:
Act as a liaison between payors, internal departments, and external regulatory agencies regarding credentialing inquiries and requirements
Continuous Improvement:
Identify opportunities for process improvement within the credentialing workflow and implement best practices
Stay updated on industry trends, regulatory changes, and best practices in credentialing
NCPDP Registration & Compliance:
Maintain and update NCPDP provider profiles, ensuring accuracy and compliance with industry regulations.
Assist pharmacies with initial NCPDP registration, renewals, and updates.
Monitor NCPDP-related changes and ensure pharmacies adhere to new standards and best practices.
Other duties as assigned by direct supervisor
Qualifications:
Bachelor’s degree in healthcare administration, business administration, or a related field preferred.
Minimum of 2 years of experience in credentialing within a healthcare setting, preferably related to home infusion or specialty pharmacy.
Strong knowledge of payor credentialing processes, regulatory compliance, and healthcare laws.
Excellent organizational and time-management skills with a keen attention to detail.
Proficient in using credentialing software and Microsoft Office Suite.
Understanding of healthcare compliance standards, including CMS, ACHC, and URAC.
Benefits:
Competitive salary and benefits package.
Opportunities for professional development and advancement.
A collaborative and supportive work environment.
Title: AI Legal Drafting Specialist
Company: Filevine
Location: Salt Lake City, UT
