Senior Provider Relations Analyst – Contract Negotiation

This is a fully remote position, open to applicants in United States.

📋 Description

• Oversee the contracting activities for Prime’s independent pharmacy network.

• Investigate and address inquiries related to pharmacy contracts.

• Assess network participation and disseminate pharmacy contract documents.

• Coordinate the accurate, timely, and complete submission, tracking, storage, and distribution of contract deliverables.

• Ensure that contractual obligations meet company policies, regulatory standards, and legal requirements.

• Collaborate with Legal and Network Management leadership to guarantee that contract language is precise and succinct.

• Build, nurture, and sustain relationships with independent pharmacy providers.

• Handle legal correspondence between Prime and independent pharmacy providers, escalating issues to Prime Legal Counsel when necessary.

• Perform root cause analyses on complaints and issues related to pharmacy contracts and pricing.

• Evaluate pharmacy complaints, issues, and grievances, working closely with Network Management, Client Engagement, and Benefit Operations.

• Manage and update Prime’s Provider Manual to ensure compliance and timely distribution.

• Contribute to process enhancements that support cross-functional projects, regulatory updates, and client implementations.

• Carry out other duties as assigned.

⛳️ Requirements

• Bachelor's degree in Business or a related field, or an equivalent combination of education and relevant work experience.

• High school diploma or GED is required.

• Minimum of 5 years of experience in a call center, customer service, operations, retail pharmacy, pharmacy technician role, or Pharmacy Benefit Management (PBM).

• Must be authorized to work in the United States without the need for a work visa or residency sponsorship.

• Strong interpersonal communication skills, encompassing conflict resolution and active listening.

• Advanced problem-solving skills and the ability to interpret complex data.

• Proficiency in Microsoft Outlook, Word, and Excel.

• Capability to manage multiple tasks and projects simultaneously under tight deadlines.

• Ability to thrive in a fast-paced, team-oriented environment.

• Skill in establishing rapport and effectively influencing individuals at all organizational levels.

• Preferred: experience in analyzing state and federal regulations.

• Preferred: familiarity with RxClaim or other claims processing systems.

• Preferred: Pharmacy Technician certification (CPhT) or equivalent pharmacy experience.

• Preferred: experience in contract negotiations.

• Preferred: experience with Salesforce.

• Preferred: expertise in reviewing and responding to contract-related inquiries.

• Preferred: experience in reviewing and managing contract redlines.

• Preferred: experience in supporting or coordinating contract execution.

• Must adhere to job-specific security responsibilities, as well as applicable legal, regulatory, and contractual obligations, along with internal policies and procedures.

• Must be capable of performing the essential functions of the job; reasonable accommodations may be available.

🏝️ Benefits

• Competitive pay based on experience and skills.

• Access to benefits, incentives, and additional compensation through Prime’s Benefits Page.

• Reasonable accommodations available for employees with disabilities.

• Tobacco-Free Workplace.