Pharmacy Compliance and Quality Administrator (remote-East coast preferred)
Company: BlueCross BlueShield of South Carolina
Location: Columbia
Posted on: February 25, 2021
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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
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