Medicaid PBM Contract Administrator

Logistics:

This position is REMOTE, full-time (40-hours/week) Monday-Friday.

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 proficiency in spelling, punctuation, and grammar.

  • Ability to handle multiple complex projects with competing deadlines.

  • Ability to independently assess both internal and external requirements and reprioritize quickly.

  • Capability to use available resources to overcome challenges and complete assignments.

• Required Software and Tools: Microsoft Office skills, including Excel, PowerPoint, Word, Outlook, SharePoint and Teams

We Prefer That You Have the Following:

• Strong Excel skills

• Master's Degree or 6 years direct work experience

• 8+ years in the pharmacy retail industry, payer relations experience, or drug supply chain/PBM.

• 3+ years contracting analytics experience (may be concurrent).

• 1 year in project management.

Our comprehensive benefits package includes the following:

We offer our employees great benefits and rewards. You will be eligible to participate in the benefits the first of the month following 28 days of employment.

• Subsidized health plans, dental and vision coverage

• 401k retirement savings plan with company match

• Life Insurance

• Paid Time Off (PTO)

• On-site cafeterias and fitness centers in major locations

• Education Assistance

• Service Recognition

• National discounts to movies, theaters, zoos, theme parks and more

What We Can Do for You:

We understand the value of a diverse and inclusive workplace and strive to be an employer where employees across all spectrums have the opportunity to develop their skills, advance their careers and contribute their unique abilities to the growth of our company.

What to Expect Next:

After submitting your application, our recruiting team members will review your resume to ensure you meet the qualifications. This may include a brief telephone interview or email communication with our recruiter to verify resume specifics and salary requirements.

Management will be conducting interviews with those candidates who are the most qualified, with prioritization given to those candidates who demonstrate the required qualifications.

We participate in E-Verify and comply with the Pay Transparency Nondiscrimination Provision. We are an Equal Opportunity Employer.

Some states have required notifications. Here's more information.

BlueCross BlueShield of South Carolina and our subsidiary companies maintain a continuing policy of nondiscrimination in employment to promote employment opportunities for persons regardless of age, race, color, national origin, sex, religion, veteran status, disability, weight, sexual orientation, gender identity, genetic information or any other legally protected status. Additionally, as a federal contractor, the company maintains Affirmative Action programs to promote employment opportunities for minorities, females, disabled individuals and veterans. It is our policy to provide equal opportunities in all phases of the employment process and to comply with applicable federal, state and local laws and regulations.

We are committed to working with and providing reasonable accommodations to individuals with physical and mental disabilities.

If you need special assistance or an accommodation while seeking employment, please e-mail mycareer.help@bcbssc.com or call 1-800-288-2227, ext. 47480 with the nature of your request. We will make a determination regarding your request for reasonable accommodation on a case-by-case basis.