Lumicera

Lumicera - Lumicera Health Services Powered by Navitus - Innovative Specialty Pharmacy Solutions- Lumicera Health Services is defining the “new norm” in specialty pharmacy to optimize patient well-being through our core principles of transparency and stewardship. Here at Lumicera, our team members work in an environment that celebrates creativity and fosters diversity.

USD $55,151.00 - USD $66,447.00 /Yr.

M-F 8am-5pm, CST

Due to growth, we are adding this Contracting and Audit Specialist to our Trade Relations department.

 

The Contracting and Audit Specialist will assist with the business needs of the payer relations and contracting team which may include supporting proactive contracting compliance to prepare for and/or mitigate future audits, and respond to requested audits, prescription validations, and audit responses such appeals and requests for additional information. The primary responsibility of this position is to effectively manage all payer program compliance and responding to all payer requests. The Contracting and Audit Specialist will support and report to the Manager, Payer Contracts.    The Contracting and Audit Specialist will support the Lumicera and all strategic partners that Lumicera provides shared services for to help meet strategic goals and mitigate financial losses from payers. The Contracting and Audit Specialist will interface with business leaders, pharmacists, legal, compliance, and external vendors with respect to specialty pharmacy services and audit duties.

 

Is this you? Find out more below!

How do I make an impact on my team? 

• Participate in projects and workgroups to achieve business goals and strategy. 
• Participate and work on projects involving third-party payer contracts, relations, and program compliance.
• Manage project timelines and objectives and participate in projects to assist with administrative actions items and task that better serve the business needs of the organization.  
• Prepare audit responses to meet the requested information by payers, government bodies, accreditation bodies, and third party organizations support payer and government clients.
• Work with stakeholders to retrieve required information to provide reports and additional information requested for compliance with payer contracts, accreditation standards, and government regulations.
• Complete credentialing and new contract applications for vendors including payer and government clients.
• Compile supporting documents and reports for payer applications, contracts, business reviews, audits, and ad hoc business requests.
• Track agreements through the contracting process from reception to completion with both internal and external stakeholder input 
• Meet with payer representatives to determine account management needs of the payer and ensuring contract compliance
• Other duties as assigned

What our team expects from you?

• High School degree or equivalent required
• Bachelor’s degree preferred
• Certified Pharmacy Technician preferred
• At least 5 years of pharmacy, payer, audit or similar experience.
• Experience with Microsoft Excel, Word or equivalent is preferred.
• Participate in, adhere to, and support compliance program objectives
• The ability to consistently interact cooperatively and respectfully with other employees

What can you expect from Navitus?

• Top of the industry benefits for Health, Dental, and Vision insurance
• 20 days paid time off
• 4 weeks paid parental leave
• 9 paid holidays
• 401K company match of up to 5% - No vesting requirement
• Adoption Assistance Program
• Flexible Spending Account
• Educational Assistance Plan and Professional Membership assistance
• Referral Bonus Program – up to $750!

 

Lumicera Health Services Powered by Navitus

Innovative Specialty Pharmacy Solutions- Lumicera Health Services is defining the “new norm” in specialty pharmacy to optimize patient well-being through our core principles of transparency and stewardship.  Here at Lumicera, our team members work in an environment that celebrates creativity and fosters diversity.

 

We are unable to offer remote work to residents of Alaska, Hawaii, Maine, Mississippi, New Hampshire, New Mexico, North Dakota, Rhode Island, South Carolina, South Dakota, West Virginia, and Wyoming

 

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