Pharmacy Licensing/Credentialing Analyst
About The Position
The Pharmacy Licensing/Credentialing Analyst is responsible for accurate and timely facility and professional licensing and credentialing for health plans and pharmacy benefit managers (PBMs) across all pharmacy sites. The role manages pharmacy license tracking, applications, renewals, credentialing and re-credentialing, and related regulatory and accreditation requirements. It also maintains pharmacy and provider profiles and supports accreditation renewals. The position is hybrid and based in Lake Mary, Florida; associates must live within a reasonable commuting distance and work in the office 1–2 days per week. Hours are general business hours, Monday through Friday.
Requirements
- High school diploma and a minimum of 3 years of experience, or an equivalent combination of education and experience.
- Must live within a reasonable commuting distance of Lake Mary, Florida.
Nice To Haves
- Previous experience with pharmacy licensure through state pharmacy boards is strongly preferred.
- Knowledge of Medicaid, Medicare, managed care, and PBM providers is preferred.
Responsibilities
- Manage and maintain the pharmacy license tracking tool and advise pharmacy sites and pharmacists about license renewals.
- Submit new pharmacy license applications and renewals for all pharmacy sites.
- Maintain the confidentiality of pertinent pharmacy and provider information.
- Administer credentialing and re-credentialing to ensure compliance with regulatory, accreditation, and managed care plan policies, protocols, standards, and requirements.
- Develop collaborative relationships with managed care plans, state agencies, and PBMs to facilitate timely credentialing and re-credentialing applications.
- Track credentialing and re-credentialing and ensure time-sensitive materials are completed.
- Review credentialing policies and procedures for accuracy and completeness.
- Complete new Medicaid applications and renewals or revalidations.
- Maintain NCPDP profiles for all pharmacy sites.
- Request certificates of insurance and distribute them to plans or CMS.
- Update NPI profiles in NPPES.
- Support URAC, ACHC, and NABP accreditation renewals.
- Submit Pharmacist in Charge state license changes and renewals.
- Perform additional responsibilities as assigned.
Benefits
- Merit increases
- Paid holidays
- Paid time off
- Incentive bonus programs, unless covered by a collective bargaining agreement
- Medical benefits
- Dental benefits
- Vision benefits
- Short- and long-term disability benefits
- 401(k) with matching
- Stock purchase plan
- Life insurance
- Wellness programs
- Financial education resources
Stand Out From the Crowd
Upload your resume and get instant feedback on how well it matches this job.
What This Job Offers
Job Type
Full-time
Career Level
Mid Level
Education Level
High school or GED
