Contract Coordinator Job in Woonsocket, Rhode Island Us
Position Summary:
POSITION SUMMARY
CVS Caremark is a Fortune 21 company with 200,000 employees and over $90B in revenue. It is the only fully integrated pharmacy health care company in the United States. Our offerings across the entire spectrum of pharmacy care allow us to provide greater convenience and choice for patients, improve health outcomes, and lower overall health care costs for plan sponsors and participants.
The Contract Coordinator will coordinate contracting processes to ensure that CVS pharmacies are enrolled in appropriate third party programs. Additionally this individual will communicate new contract requirements to Payer Relations Coding to facilitate claim submission. The individual in this position will also act as a liaison between internal departments within the organization and external contacts such as health plans, processors, pharmacy benefit managers, and governmental agencies relative to contractual relationships and/or prescription processing.
Job Description:
The Contract Coordinator is responsible for but not limited to:
• Thoroughly review correspondence, bulletins, announcements and other communications distributed by PBMs, processors, health plans, the state Medicaid programs and Medicare in order to make informed decisions relative to impact on prescription processing.
• Ensure that both CVS and the agency are in compliance with State and Federal guidelines, NCPDP Standards, and/or per the terms of a contract.
• Evaluate information received to determine if an internal system update is required, and prepare necessary documentation to facilitate new third party codes, existing third party code changes, and third party code terminations.
• Serve as a liaison between CVS and agencies to address/clarify issues and maintain good working relationships.
• Review contracts for pertinent information to ensure that language adheres to CVS standard contractual language and to understand our contractual relationship.
• Maintain contracts by entering contract elements into database, preparing documents for scanning to facilitate retrieval, and terminating existing agreements when replaced by new agreements.
• Support field and internal departments within the organization via response to Help Desk Log escalations, Pharmacy Operations emails, Customer Relations inquiries, and various other inquiries throughout the organization relative to prescription benefits and claims processing.
Requirements:
Qualifications for the Contract Coordinator Position:
• Business Administration Degree and/or comparable work experience
• 4 to 7 years experience in a health care, pharmacy or medical billing environment
• Ability to work independently with minimal supervision, and as part of a team
• Exceptional organizational skills and ability to set work priorities for multiple tasks
• Excellent communication skills (written verbal)
• Ability to problem solve to resolve complex third party issues
• Capacity to multi-task urgent assignments in addition to managing day to day duties
• Commitment to excellence in work. Results oriented
• Required intermediate skills in MS Word, Excel and Access
