Pharmacy Credentialing Specialist

Job DetailsJob Location: Polaris Pharmacy Services of Ft Lauderdale - Ft. Lauderdale, FL 33309Position Type: Full TimeJob Shift: DayJob Category: Admin - ClericalWHO WE ARE At Polaris Pharmacy Services, we’re more than a pharmacy — we’re a dedicated partner in care, transforming how patients experience long-term, post-acute, correctional, PACE, and specialty pharmacy services. As industry leaders, we’re raising the bar for quality and coordination across all sites of care, ensuring every patient receives seamless, compassionate, and expert support. Founded in 2015, Polaris is proud to be locally and independently owned, with a growing national footprint. Our team thrives in a mission-driven environment where innovation meets purpose, and every role contributes to making a real impact. We offer more than just a job — we provide competitive pay, robust benefits, and genuine opportunities for career advancement. If you're passionate about shaping the future of pharmacy and making a difference in the lives of those who need it most, we invite you to grow with us. Job Summary: The Pharmacy Credentialing Specialist is responsible for managing the credentialing, enrollment, and network participation processes for the pharmacies. This role ensures accurate and timely completion of payer applications, pharmacy enrollment requirements, contract documentation, and database maintenance across all lines of business, including PBM/Payer, PSAO, NCPCP, Medicare, and Medicaid. The Specialist serves as the primary point of contact for payer network participation matters and maintains organized, up-to-date records of all contractual agreements.   Duties/Responsibilities: Credentialing & Enrollment: Complete, submit, and track credentialing and re-credentialing applications for PBMs, payers, PSAOs, Medicare, and Medicaid programs.  Ensure all enrollment applications are accurate, complete, and submitted within required timeframes to avoid lapses in network participation and additional fees.  Monitor application status and follow up proactively with payers, PSAOs, and government programs to resolve delays or missing information.  Maintain awareness of enrollment deadlines, revalidation cycles, and renewal requirements for all applicable programs.  Contract & Documentation Management: Maintain complete, organized copies of all executed contracts and agreements (PBM/Payer, PSAO, Medicare, Medicaid) in a shared drive, ensuring version control and easy retrieval.  Review contract terms, effective dates, and amendments to ensure compliance with enrollment and credentialing obligations.  Track contract expiration and renewal dates, flagging upcoming actions needed to maintain continuous network participation.  Database & Records Maintenance: Maintain accurate, current records of credentialing status, provider/pharmacy demographic information, and enrollment data in internal systems and payer portals.  Ensure consistency of pharmacy information (NPI, NCPDP, DEA, licensure, ownership, etc.) across all payer and regulatory databases.  Conduct regular audits of credentialing files and databases to identify and correct discrepancies.  Payer Communication & Change Notifications: Prepare and submit timely pharmacy change notifications to payers, PBMs, and PSAOs (e.g., ownership changes, address changes, NPI updates, licensure updates, pharmacist-in-charge changes).  Serve as liaison between the pharmacy and payer/PSAO representatives regarding credentialing, enrollment, and network status inquiries.  Communicate credentialing or enrollment issues to internal stakeholders and leadership in a timely manner.    Compliance & Quality  Ensure all credentialing and enrollment activities comply with applicable federal, state, and payer-specific regulations and requirements.  Stay current on changes to Medicare, Medicaid, and PBM/PSAO credentialing requirements and communicate relevant updates internally.  Support internal and external audits by providing documentation related to credentialing and contract status.  QualificationsQUALIFICATIONS/COMPETENCIES To perform this job successfully, an individual must be able to perform each essential duty satisfactorily. The requirements listed below are representative of the knowledge, skill, and/or ability required. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.   EDUCATION and/or EXPERIENCE:   High school diploma or equivalent required; Associate's or Bachelor's degree preferred.  Experience in pharmacy operations, healthcare credentialing, payer enrollment, or a related administrative role.  Familiarity with PBM, PSAO, Medicare, and Medicaid enrollment and credentialing processes.  Strong organizational skills with high attention to detail and accuracy.  Proficiency with Microsoft Office (Excel, Word, Outlook) and shared drive/document management systems.  Excellent written and verbal communication skills.  Ability to manage multiple deadlines and prioritize competing tasks independently.  Preferred:  Experience with pharmacy credentialing platforms or payer portals (e.g., NCPDP, PECOS, CAQH, state Medicaid portals).  Knowledge of pharmacy licensing, NPI/NCPDP/DEA registration processes.  Prior experience in a multi-site pharmacy, PSAO, or pharmacy services administration environment.