Job Information
Ohio State Job Bank Medicaid PBM Contract Administrator in Grove City, Ohio
Internal Reference Number: R1042253 Summary Why should you join the BlueCross BlueShield of South Carolina family of companies? Other companies come and go, but we've been part of the national landscape for more than seven decades, with our roots firmly embedded in the South Carolina community. We are the largest insurance company in South Carolina ... and much more. We are one of the nation's leading administrators of government contracts. We operate one of the most sophisticated data processing centers in the Southeast. We also have a diverse family of subsidiary companies, allowing us to build on various business strengths. We deliver outstanding service to our customers. If you are dedicated to the same philosophy, consider joining our team! Position Purpose: In this role, you will support Pharmacy Sales and Contracting by assisting in the completion of all aspects of the contract management process, from bid development through contract execution. Provide oversight of corporate and group level pharmacy agreements. Serve as a point of contact for pharmacy related legal documents, contracting terms and other related needs. Communicate with Legal, Compliance, and Pharmacy Leadership to assist in contracting and oversight activities.Description Logistics: This position is REMOTE, full-time (40-hours/week) Monday-Friday, subject changed per business needs and performance standards. What You'll Do: Assist with development, review, and negotiation of pharmacy agreements, including but not limited to Corporate PBM agreements, addenda and amendments, Pharmacy Services third-party vendor Master Services Agreements (MSA), Statements of Work (SOW) and Service Level Agreements (SLA), PBM addenda for self-funded commercial clients across the Enterprise, and pharmacy Non-Disclosure Agreements (NDA). Support negotiation for rates, value adds, and other legal and business terms, in cooperation with management, legal, internal stakeholders, and external business partners. Administer and track oversight programs to measure on-going compliance with Corporate PBM Agreements, Pharmacy Services vendor agreements and/or PBM Addenda for self-funded commercial clients across the Enterprise. Support audit activities at the corporate and group level. Assist with coordination of corporate or self-funded employer PBM proposal development, as assigned by management. Understand and verbally articulate status and alignment of corporate and group PBM terms within RFPS, RFIS, RFQS, as well as other documents. Create and maintain tracking of required activities in corporate RFP process. May assist with sales support activities such as preparing/giving presentations to prospective customers, etc. Partner with Legal, Compliance, Finance, Books and Contracts and other business units to minimize and mitigate risk. Ensure compliance with all government regulations and internal policies and procedures. Create and maintain project plans to manage and execute all assigned projects with the ability to provide current project status when requested.. To Qualify for This Position, You'll Need the Following: Required Education: Bachelor's Degree Degree Equivalency: 4 years job related work experience or Associate's and 2 years job related work experience. Required Work Experience: 5+ years in the drug supply chain/PBM or health-plan/ healthcare/ pharmacy contracting, auditing, oversight and/or compliance. 3 years contracting analytics experience (may be concurrent). Required Skills and Abilities: Knowledge in contracting and regulatory oversight, linking to business processes contract language. Strong communication and presentation skills. Time management skills and the ability to work effectively in an independent setting. Excellent organization and attention to detail, with proficie