Pharmacy Compliance and Quality Administrator (remote-East coast preferred)

Company: BlueCross BlueShield of South Carolina
Location: Columbia
Posted on: February 25, 2021

Job Description:

Pharmacy Compliance and Quality Analyst (remote--East Coast preferred)Supports the Director of Pharmacy Administration and Oversight by executing all aspects of the contract management process, including production and oversight of PBM Addenda and Non-Disclosure Agreements, coordination of self-fund group pharmacy audit activities and requests for market check evaluations, and activities required to support the contract management and oversight for the Corporate PBM Agreements. Serve as primary point of contact for pharmacy related legal documents, rate/pricing management and other related needs. Will also assist with contract terms and ensures all parties are accountable for their role in the business development and contracting process.Description30% Review, develop, redline, and negotiate--PBM Addenda for self-funded commercial clients--across the Enterprise, in cooperation with management, legal, internal stakeholders, and external business partners. Negotiate rates, value adds, service level agreements (SLA) and other legal and business terms.30% Review, develop, redline, and negotiate third-party vendor contracts, including Master Service Agreements (MSA), Statement of Work (SOW), Non-Disclosure Agreements (NDA) and amendments in cooperation with legal, internal stakeholders, and external business partners. Negotiate rates, value adds, service level agreements (SLA) and other legal and business terms.20% Conducts and oversees oversight programs to measure on-going compliance with Corporate PBM Agreement. 10%--Partner with Legal, Finance, Books and Contracts and other business units to minimize and mitigate risk. In collaboration with internal stakeholders, develop and lead, key supplier Quarterly Business Review (QBR) process. Ensure compliance with all government regulations and internal policies and procedures.10% Create project plans to manage and execute all assigned projects.Required Education:-- Bachelor's degree OR-- Four years in a Health Science related field.Preferred Education: -- Bachelor's degreeWork Experience:-- Five years in the pharmacy industry, payer relations experience, or drug supply chain/PBM.-- Three years of contracting analytics experience (may be concurrent).Preferred work experience:-- Five years of Pharmacy Benefits Manager experience.-- Previous Paralegal experience.Required Skills and Abilities:-- Advanced knowledge of pharmacy business support and systems concepts.-- Able to communicate persuasively and successfully with technical and non-technical audiences, including the ability to express complex technical and business concepts to management, peers, and business units.-- Strong resource management, and interpersonal skills.-- Strong analytical and conceptual skills.-- Demonstrated understanding of how projects and implementations affect an organization and can successfully link it to business processesPreferred Skills and Abilities:-- Data Analytics experience.Required Software and Other Tools:-- Advance Microsoft OfficePreferred Licenses and Certificates:-- Certified in Healthcare Compliance (CHC).*

Keywords: BlueCross BlueShield of South Carolina, Columbia , Pharmacy Compliance and Quality Administrator (remote-East coast preferred), Healthcare , Columbia, South Carolina