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. This hybrid role is based in Lake Mary, Florida, and requires living within a commutable distance. Associates work general business hours Monday through Friday and are required to be in the office one to two days per week. The analyst manages pharmacy license tracking, submits new pharmacy license applications and renewals, and handles credentialing and re-credentialing to ensure compliance with regulatory, accreditation, and managed care plan requirements. The role also supports pharmacy site and pharmacist licensing, Medicaid applications and renewals, pharmacy profile maintenance, insurance documentation, NPI updates, and accreditation renewals. The analyst maintains confidentiality and works collaboratively with managed care plans, state agencies, and PBMs.
Requirements
- High school diploma and at least 3 years of experience, or an equivalent combination of education and experience.
- Must live within a commutable distance of the Lake Mary, Florida location.
- Ability to work general business hours Monday through Friday and in the office one to two days per week.
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 in accordance with regulatory, accreditation, and managed care plan policies, protocols, standards, and requirements.
- Develop and foster collaborative relationships with managed care plans, state agencies, and PBMs to facilitate timely credentialing and re-credentialing applications.
- Track credentialing and re-credentialing to ensure compliance with time-sensitive requirements.
- Review credentialing policies and procedures for accuracy and completeness.
- Complete new Medicaid applications, renewals, and revalidations.
- Maintain the NCPDP profile for all pharmacy sites.
- Request and distribute Certificates of Insurance to plans or CMS.
- Update NPI profiles through 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 insurance
- Vision insurance
- Short- and long-term disability benefits
- 401(k) with match
- 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
Entry Level
Education Level
High school or GED
