Credentialing & Third-Party Compliance Specialist- Pharmacy Operations

Are you friendly, dependable, and passionate about working with people?  At Coborn’s, Inc., we love serving our guests, supporting our communities, and helping our team members grow their careers.  If you’re looking for a place where you can build a future while making a positive impact every day, we’d love to talk to you about joining our team!

Coborn's, Inc. is a fast-growing, employee-owned grocery retailer proudly serving communities across the Midwest. Our family of grocery stores includes Coborn's, Cash Wise Foods, Marketplace Foods, Hornbacher's, Tadych’s Marketplace Foods, Sullivan’s Foods, and Kessler’s. We offer our guests an elevated shopping experience—both in-store and online—focused on freshness, value, and convenience. Guided by our company vision to inspire happiness, healthy living, and simplicity, this principle has fueled our growth for more than 100 years and is at the heart of everything we do.

Coborn’s, Inc. also owns and operates liquor stores under the Coborn’s Liquor, Cash Wise Liquor, Andy’s Liquor, and Captain Jack’s brands. In addition, we operate fuel kiosks and convenience store locations under the Little Dukes and Coborn’s Express names. Many of our grocery stores also feature full-service pharmacies to support the health and wellness of our guests. We manage a variety of other retail businesses in markets where the fit is right, including Ace Hardware, Country Floral Gifts & Greenhouse, Caribou Coffee, Dunn Brothers Coffee, Erbert and Gerbert’s, Godfather’s Pizza, and Pet Supplies Plus. To support our diverse retail operations, we operate our own central bakery, fresh foods commissary, and grocery warehouse and distribution center.

Join the Coborn’s Pharmacy Team as our Credentialing & Third-Party Compliance Specialist! If you have a passion for the Pharmacy industry and a knack for compliance, this position will allow you to continue growing your knowledge in both.  In this role, you will have direct responsibility for managing pharmacy and staff credentialing across all markets, as well as overseeing third-party contract administration and collections.  You will also partner and support our Director of Pharmacy Operations with high-level administrative and compliance initiatives.

Our Pharmacy Team has a REMARKABLE team of professionals who are to help you grow and succeed in your career. Give it a shot and apply today! 

Credentialing & Compliance

Ensure all pharmacy sites and staff maintain current credentials and are in full regulatory compliance:

• Maintain all pharmacy licenses, DEA and Medicare registrations, NCPDP/NPI numbers, and other required business documentation.
• Maintain accurate and timely documentation, including Board of Pharmacy licenses, DEA, NCPDP/NPI numbers, Medicare registration, and wholesale licenses.
• Ensure pharmacists, technicians, and other clinical staff maintain required licenses, immunization credentials, and CE compliance.
• Develop and maintain credentialing tracking systems, reporting tools, and internal documentation to support regulatory compliance.
• Act as the subject matter expert and point of contact for all credentialing and licensing inquiries.
• Continuously assess and improve credentialing processes to enhance accuracy, efficiency, and risk mitigation.

Third-Party Contracts & Payer Relations

Manage all third-party payer agreements and communications:

• Manage the full lifecycle of third-party contracts, including commercial, Medicare, Medicaid, and other payer agreements.
• Interpret contract terms, reimbursement structures, and payer updates; communicate impacts across the pharmacy network.
• Build and maintain strong relationships with payer representatives, PSAO partners, and claims managers.
• Collaborate with Pharmacy leadership to negotiate terms and ensure favorable reimbursement structures.
• Work cross-functionally with billing and A/R teams to ensure alignment between contract terms, claims adjudication, and payment reconciliation.
• Lead the tracking and resolution of third-party audits, using results to drive process improvements.

Administrative & Operational Support

Support operational initiatives and development goals:

• Contribute to strategic projects including new pharmacy openings, ensuring all contracting and licensing requirements are met.
• Support Medicare accreditation and CMS compliance efforts.
• Assist in the planning and coordination of department events and leadership meetings.

Policy & Procedure Management

Maintain and update pharmacy operational policies:

• Develop, update, and manage policies related to licensing, credentialing, payer compliance, and billing practices.
• Ensure pharmacy operations remain aligned with HIPAA, Fraud/Waste/Abuse policies, and all applicable federal/state regulations.
• Generate reports to support internal audits and ensure enterprise-wide compliance.

We believe that building a team of people with different backgrounds, beliefs, experiences and perspectives inspires fresh thinking and opens us up to new possibilities. We are an EEO/AA Employer - All qualified individuals, including minorities, females, veterans and individuals with disabilities are encouraged to apply.

Our remarkable employees are at the heart of everything we do. At Coborn’s, we’re committed to creating a supportive and rewarding workplace—one that offers a vibrant, team-oriented environment, ongoing career growth, and meaningful benefits. As an employee-owned company, we believe in investing in our people and their futures.

We’re proud to offer a variety of benefits to both our full-time and part-time employees, including: 

• 10% Employee Discount (for the employee and their immediate household) at our grocery and franchise locations (Ace Hardware, Caribou Coffee, Erbert and Gerbert’s, and Pet Supplies Plus)
• Get Paid Daily with DailyPay – for employees who would like access to their pay before payday, we offer this great benefit!
• Paid Time Off (PTO/Vacation)
• Paid Floating Holidays & 1 - ½ time for hours worked on a company-recognized holiday!
• Paid Military Leave
• Employee Health & Wellness Programs, Challenges and Resources – to assist our team members in living a life of wellbeing!
• Employee Assistance Program (EAP) – unlimited phone access to legal, financial, and work-life services and up to five free in-person counseling sessions, per situation/issue, per year
• Tools, resources and opportunities for career growth and development
• 401(k) plan options – we also match up to 20% of the first 5% contributed
• Participation in our Employee Stock Ownership Program (ESOP) – yes, we’re employee-owned! Our team members benefit from the success of the company through this company-sponsored benefit!
• Additional Voluntary Benefits – such as vision, accident and critical illness insurances

If you’re hired or promoted into a full-time position with our company, you will also be eligible for: Medical & Dental Insurance, Health Savings Account (HSA), Flexible Spending Account (FSA), Tuition Reimbursement, Adoption Reimbursement, Paid Family Caregiver Leave, as well as company-sponsored Term Life Insurance, Accidental Death & Dismemberment Insurance, and Short-Term & Long-Term Disability Insurance!

As a member of our team, you can also expect:

• Flexible scheduling - We understand that many of our employees are trying to juggle school, practice, family time, errands and personal hobbies, all with only about 16 hours of awake time in a day.
• Recognition - We celebrate a culture of recognition, encouraging employees to recognize and thank one another for remarkable behavior. We even have an app for that!
• Growth Opportunities - We're always looking for motivated, high-potential employees who want to be part of our next generation of leaders! There are opportunities to grow within our company to positions you may not yet even know exist. Coborn's, Inc. offers a variety of development programs for employees who want to grow their careers with us. 

Our culture celebrates employee ideas and encourages creative innovations. We're growing, learning, and overflowing with energy. In a dynamic atmosphere that welcomes diversity, we are investing in our employees, along with the growth of our company. We invite you to join us in carrying out our vision to “Be Remarkable!” Apply today!

Starting pay is determined based on several factors, which can include the candidate's experience, qualifications, skills, education, and geographic area. 

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Salary : $55,000 - $87,000