About this role
This senior role manages pharmacy provider relations contracting and the independent pharmacy network for Prime. You will resolve pharmacy contract inquiries, maintain the Prime Provider Manual for compliance, and perform root cause analysis on contract and pricing complaint issues.
Key Responsibilities
- Manage independent pharmacy network contracting activities,Research and resolve pharmacy contract inquiries and distribute contract documents,Ensure contract obligations meet company policies, regulatory compliance, and legal requirements,Maintain and edit Prime’s Provider Manual for compliance and distribution,Conduct root cause analysis and resolve pharmacy contract/pricing complaint issues
Technical Overview
The role is centered on contracting operations, documentation tracking, and compliance workflows for pharmacy networks. It requires strong data interpretation and process discipline using Microsoft Outlook, Word, and Excel, along with coordination across legal and network management stakeholders.
Ideal Candidate
The ideal candidate is a senior provider relations professional with 5+ years of experience across call center operations, customer service, retail pharmacy, pharmacy technician work, or Pharmacy Benefit Management (PBM). They have strong experience managing pharmacy contracting and independent pharmacy networks, maintaining a provider manual, handling escalated inquiries, and performing root cause analysis with excellent communication and proficiency in Microsoft Outlook, Word, and Excel.
Must-Have Skills
5 years of work experience in a call centercustomer serviceoperationsretail pharmacypharmacy technicianPharmacy Benefit Management (PBM)Contracting efforts and managing independent pharmacy networksResearch and resolve pharmacy contract related inquiresEnsure contracting and network participation documentation submission is timelyaccurateand completeEnsure contractual obligations adhere with company policiesregulatory compliance and legal requirementsEstablishdevelopand maintain relationships with independent pharmacy providersManage Prime’s Provider Manual to ensure compliance and timely distributionProficiency within Microsoft applications such as OutlookWord and Excel
Nice-to-Have Skills
Not specified
Tools & Platforms
Microsoft OutlookMicrosoft WordMicrosoft Excel
Required Skills
Pharmacy contractingindependent pharmacy network managementPrime Provider Manual managementregulatory compliancelegal requirementslegal-to-legal correspondenceroot cause analysispharmacy contract pricing analysis complaints resolutionhandling complaints issues and grievancesMicrosoft OutlookMicrosoft WordMicrosoft ExcelPharmacy Benefit Management (PBM)call center operationscustomer serviceretail pharmacyprovider relationship management
Hard Skills
Pharmacy contractingNetwork managementPrime Provider Manual managementProvider manual editingContract deliverables submissionElectronic and physical tracking of contract documentsDocument storage and distributionRegulatory complianceLegal-to-legal correspondenceRoot cause analysisInvestigating pharmacy contract and pricing analysis complaints issuesMonitoring pharmacy contract and pricing analysis complaints issuesReporting pharmacy contract and pricing analysis complaints issuesHandling pharmacy inquiries (complaintsissues and/or grievances)Data interpretationMicrosoft OutlookMicrosoft WordMicrosoft ExcelCustomer serviceCall center operationsPharmacy Benefit Management (PBM)
Soft Skills
Interpersonal communicationConflict resolutionListeningProblem solvingRelationship management with providersEscalation managementCross-functional collaboration
Keywords for Your Resume
Provider Relations Analyst SrSenior Provider Relations Analystlicense pharmacistpharmacy contractingindependent pharmacy network contractingPrime Provider Manualnetwork management strategiespharmacy contract documentscontract deliverablescontract document trackingregulatory compliancelegal requirementslegal-to-legal correspondencesPrime Legal Counselroot cause analysispharmacy contract pricing analysiscomplaintsissuesgrievancespharmacy provider manualMicrosoft OutlookMicrosoft WordMicrosoft ExcelPharmacy Benefit ManagementPBMcall centercustomer serviceretail pharmacyindependent pharmacy networkpharmacy complaints
Deal Breakers
Bachelor's degree in Business or related area (or equivalent) OR high school diploma/GED required, Must have 5 years of relevant experience in call center, customer service, operations, retail pharmacy, pharmacy technician, or PBM, Must be eligible to work in the United States without work visa or residency sponsorship
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