Provider Relations Lead (Onsite) – Boston

«out Conduent Through our dedicated associates, Conduent delivers mission-critical services and solutions on behalf of Fortune 100 companies and over 500 governments – creating exceptional outcomes for our clients and the millions of people who count on them. You have an opportunity to personally thrive, make a difference and be part of a culture where individuality is noticed and valued every day. Job Description Provider Relations Lead (Onsite) – Boston Summary: The Provider Relations Lead establishes and maintains relationships among the state’s pharmacy program for drug and related services. Organize provider training sessions that provide rules and regulations education. Work with other agencies and stakeholders for pharmacy claims resolutions. Responsibilities: Conduct annual provider training management for pharmacists and technicians Oversee call center services (resolving escalated tickets, providing training, and providing reporting Evaluates and responds to claims processing discrepancies Provide software vendor certification, pharmacy claim recovery, and new provider claim testing Provides implementation support to new pharmacies Is a mediator between pharmacies and software vendors for claim/system adjudication Primary contact for pharmacists and pharmacy technicians seeking assistance with electronic pharmacy claims billing Executes effective responses to all issues from the call center Assists with drug rebate reporting and reconciliation Performs drug rebate analysis Performs claims adjudication and metrics analysis Gives bi-weekly presentations to Pharmacy director and pharmacy team Qualifications Education: Bachelor’s degree or equivalent experience Experience: 5 years Provider Relations or related experience 5 years Pharmacy Benefits Management (PBM) or related experience Skills/Knowledge: NCPDP Standards knowledge preferred, but not required Proficiency with Microsoft Office suite Excellent communications and interpersonal skills Ability to handle multiple tasks Must be able to pass a background/drug test Must be able to work in the U.S without assistance Closing Conduent is an Equal Opportunity Employer and considers applicants for all positions without regard to race, color, creed, religion, ancestry, national origin, age, gender identity, gender expression, sex/gender, marital status, sexual orientation, physical or mental disability, medical condition, use of a guide dog or service animal, military/veteran status, citizenship status, basis of genetic information, or any other group protected by law. People with disabilities who need a reasonable accommodation to apply for or compete for employment with Conduent may request such accommodation(s) by clicking on the following link, completing the accommodation request form, and submitting the request by using the