The Licensing & Credentialing Specialist is responsible for the submission, follow-up, and maintenance of all components of pharmacy licensing, credentialing, and regulatory research; and serves in the capacity of a Subject Matter Expert (SME). This role also supports managed care contracting efforts and special projects.

ESSENTIAL FUNCTIONS:

• Responsible for completing and submitting initial applications, following up on application submission, and the ongoing maintenance of State pharmacy licenses for the organization.
• Fulfill all legal requirements with State and Federal agencies to include licensure for new locations and updates to current registrations.
• Initial credentialing and maintenance of government pharmacy contracts to include Medicare and Medicaid.
• Communicate frequently with internal and external customers on pharmacy licensure status.
• Act as the liaison for any inquiries related to licensure issues.
• Maintain a database of license expiration dates for renewals as necessary.
• Maintain a database of Pharmacist license and Pharmacy Technician registration expiration dates.
• Recordkeeping of state licensure, DEA, Controlled Substance licenses.
• Proactively identify and escalate potential licensure issues.
• Strict confidentiality of pharmacist-in-charge and ownership information.
• Assist in managing formal communication with Pharmacy Benefit Managers and Managed Care Organizations.
• Other duties as assigned.

REQUIRED QUALIFICATIONS:

• Must possess pharmacy environment experience 

PREFERRED QUALIFICATIONS:

• Thorough knowledge of State and Federal regulatory guidelines 
• 5 years’ experience in the healthcare industry, pharmacy regulatory experience 
• Pharmacy Audit Experience 
• Certified Pharmacy Technician registration or related experience working in a pharmacy 
• Minimum 2-3 years of experience working in a pharmacy dispensing system

COMPETENCIES:

• Initiative, professional in conduct and appearance, punctual, efficient.
• Must be able to multi-task and work well under pressure. Able to work in the office or remotely.
• Must be proactive, responsive, and resourceful with excellent follow-up and organizational skills.
• Highly flexible and motivated individual with an ability to work independently as well as in a team setting.
• Must consistently demonstrate the highest level of professionalism and discretion.
• Strong interpersonal skills with the ability to interact well with all levels of clients, customers, and internal personnel.
• Must be receptive to instruction with a high regard for customer service.
• Excellent computer skills in a Microsoft Windows environment.
• Must exhibit a high level of confidentiality.