Specialist, Contracting and Audit

Lumicera Health Services is seeking a Contracting and Audit Specialist to join our team!

• Complete credentialing and new contract applications for vendors including payer and government clients
• Compile supporting documents and reports for payer applications, contracts, business reviews, audits, and ad hoc business requests
• Track agreements through the contracting process from reception to completion with both internal and external stakeholder input
• Re-enroll and re-credential existing payer and government plans. Monitor to proactively reenroll and resubmit to ensure no gaps in coverage
• Coordinate payer access roadmap for expanded payer contracts and investigate current networks where Lumicera and its partner pharmacies are not in network with
• Conduct internal testing, sampling, and auditing of operational and documentation processes to ensure compliance
• Analyze, compile, and prepare data analytics and presentations for payer clients
• Perform analyses and reports required for URAC, ACHC, and other accreditations as required. Assist with accreditation submissions as they pertain to evaluation and reporting
• Travel to meet with auditors and regulatory officials to meet audit and appeal standards
• Other duties as assigned

• High School degree or equivalent required
• Bachelor’s degree preferred
• Certified Pharmacy Technician preferred
• At least 5 years of pharmacy, payer, audit or similar experience
• Experience with Microsoft Excel, Word or equivalent is preferred
• Participate in, adhere to, and support compliance program objectives
• The ability to consistently interact cooperatively and respectfully with other employees

What can you expect from Lumicera?

• Top of the industry benefits for Health, Dental, and Vision insurance
• 20 days paid time off
• 4 weeks paid parental leave
• 9 paid holidays
• 401K company match of up to 5% - No vesting requirement
• Adoption Assistance Program
• Flexible Spending Account
• Educational Assistance Plan and Professional Membership assistance
• Referral Bonus Program – up to $750!