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Title: Manager - Provider Network & Central Pay Location: United States-California-Orange Job Number: 00001VQU
Under general direction of the Director Network and Managed Care Operations the Manager Provider Network and Central Pay oversees and coordinates external and internal Pharmacy Network and Pharmacy Benefit Management (PBM) administration responsibilities for Central Pay Program as well and Accounting functions for ABC Managed Care. ' Responsible for day to day workflow of receiving revenue from PBM’s and accurately forwarding funds to participating providers’ bank accounts. Manages and resolves all funds exception processes including non-matched funds missing payments and data files PBM issues and escheatment of funds back to States. Develops processes policies and procedures to effectively administer and manage GNPPN Central Pay Program. Manages team of Central Pay Specialists and Central Pay Support Representatives and provides guidance and training to GNPPN Help Desk relating to Central Pay. Manages the Financial Analyst supporting ABC Managed Care GNPPN and Prescription Savings Club expenses and revenue. Serves as System Administrator for Central Pay website. Enrolls and monitors customer and associate access to system for appropriate security. Responsible for data integrity of Central Pay databases. Hold position as Program Administrator to support ABC Treasury Dept for GNPPN’s Bank Lock Box. Facilitates problem resolution between network providers and PBM. Facilitates customer Central Pay escalation issues. Manages Central Pay website software enhancements in conjunction with software vendor. Oversees software development including testing and implementation. Works with Bank Pharmacy Benefit Managers (PBM’s) Central Pay and Reconciliation software vendors to ensure accurate processing of funds and reconciliation data. Provide guidance and support to GNPPN and Managed Care associates as well as other ABC Sales associates. Works with the Accounting and Treasury associates. Contributes to achievement of annual revenue and profitability targets. Performs additional duties as assigned. Qualifications: Requires broad training in fields such as business administration accountancy sales marketing computer sciences or similar vocations generally obtained through completion of a four year Bachelor's Degree Program and a minimum of four (4) years directly related and progressively responsible experience including two (2) years of management experience. ' ' Ability to work independently under general direction and lead colleagues in collaborative projects. Ability to direct the activities of others in such activities including training guiding developing and managing. Excellent interpersonal skills Ability to communicate effectively both orally and in writing Excellent organizational skills; attention to detail Working knowledge of computers necessary to operate effectively with company systems and programs (salesforce.com Microsoft Word/Excel/Access) Excellent customer service management skills Solid knowledge of community pharmacy operations and Pharmacy Benefit Management (PBM) companies. Thorough knowledge of ABC products programs and services Ability to interpret industry trends and competitive information; ability to develop strategies and tactics to respond to changes in the marketplace as well as communicate the trends to respective departments Job: Sales Jobs
I ensure effective communication with providers by regularly scheduling meetings, providing clear and concise information, and promptly addressing any concerns or issues they may have.
As Provider Network Managers, we are responsible for managing and maintaining the network and have to monitor network performance. We also need to identify, maintain, and install any upgrade to the network for better performance. Not only that, we should troubleshoot and repair the component of the network if it is needed. Whether the user is able to access to the network or not should also be our responsible to handle. We should perform disaster recovery plan and backup for any emergency.
Core tasks: