Payor Compliance & Credentialing Specialist

Boesen & Snow Law is a nationally recognized healthcare and pharmacy law firm headquartered in Scottsdale, Arizona, with an additional office in Indianapolis, Indiana. We focus exclusively on health and pharmacy law, representing a sophisticated client base that spans individual healthcare providers, multi-state pharmacy operators, and corporate entities across the full spectrum of healthcare delivery. This includes 503A compounding pharmacies, 503B outsourcing facilities, retail, specialty, and mail-order pharmacy operations.

Our team of 11 attorneys, three licensed pharmacists, and 15 professional staff members brings a rare combination of legal expertise and hands‑on industry knowledge to every client engagement. We advise clients on FDA and DEA regulatory compliance, pharmacy licensing and operations, professional license defense, and complex healthcare transactions. We handle matters where the stakes are high and precision is everything.

We are seeking an experienced Payor Compliance & Credentialing Specialist to join our Scottsdale team and take ownership of a broad and complex portfolio spanning PBM/Payor credentialing PBM/Regulatory Audit defense, and Pharmacy Operations Compliance. This is not an entry‑level position. We are looking for a specialist who understands the regulatory/contractual landscape governing pharmacy audit, brings hands‑on experience with payor credentialing processes, and can manage high‑volume, concurrent engagements with minimal oversight.

You will work directly alongside attorneys and pharmacist consultants, serving as the operational backbone for client engagements—guiding a credentialing matter from the initial payor application through final approval and ongoing renewal, or managing an audit response from the first discrepancy review through appeal and final resolution. Your work has direct implications for our clients' ability to operate and maintain compliance with their payor contracts.

Accuracy, accountability, and follow‑through are non‑negotiable.

Director of Payor Compliance & Credentialing

• Prepare and submit Federal/State payor credentialing applications, including gathering required documentation, interpreting application requirements, and ensuring submissions are complete and accurate
• Manage PBM network enrollment and contracting applications for pharmacy clients, including major benefit managers such as CVS Caremark, to ensure patient claim submission capability upon approval
• Serve as the primary point of contact with PBMs/Payors, managing correspondence, responding to deficiencies, and navigating state‑specific and contractual requirements with confidence
• Build and maintain robust tracking systems for deadlines, application statuses, recredentialing, and required documentation, proactively flagging risks before they become problems
• Produce clear, accurate status reports for attorneys and clients throughout the credentialing or audit lifecycle
• Support attorneys and clients during PBM/Payor audits and regulatory audits, including preparation and review of required documentation and correspondence

• Associate's or Bachelor's degree in a health‑related field, business, or equivalent experience preferred
• 3+ years of experience in pharmacy licensing, payor credentialing, or healthcare regulatory compliance
• Active CPhT certification (any U.S. state) preferred; equivalent experience considered
• Proficient in Microsoft Office (Outlook, Word, Excel)
• Strong written and verbal communication skills

• Experience with PBM network enrollment and pharmacy benefit structures, including familiarity with major payor portals such as CVS Caremark, Express Scripts, and Optum Rx
• Familiarity with federal…