- Elevance Health (Columbus, OH)
- …a strong, clinical-first lens, to deliver member-centered, lasting pharmacy care. ** Compliance Manager ** **Location:** Elevance Health supports a hybrid ... includes remote work and 1-2 days in office per week. The ** Compliance Manager ** is responsible for managing foundational and strategic compliance … more
- CVS Health (Irving, TX)
- …agencies and their contracted auditing organizations. As a Senior Manager , PBM Market Conduct Exam Support within Corporate Compliance , you will: + ... and two days from home per week The Corporate Compliance PBM Business Compliance Office...dynamic individual to join our team in a Senior Manager role. This position will perform highly complex support… more
- Medical Mutual of Ohio (OH)
- …with a strong focus on member experience. Conducts outreach to Pharmacy Benefit Manager ( PBM ) for refills, claim reprocessing and to members to provide ... with a strong focus on member experience. Conducts outreach to Pharmacy Benefit Manager ( PBM ) for refills, claim reprocessing and to members to provide… more
- Prime Therapeutics (Columbus, OH)
- …or GED is required + 5 years of progressive work experience in legal or compliance related roles for a healthcare or PBM organization, or other highly regulated ... tracking, renewing and submitting applications for licensure **Preferred Qualifications** + PBM /health care experience + Certified Compliance and Ethics… more
- Omnicell (Grapevine, TX)
- **Summary** The Manager of Licensing & Credentialing supports the OSPS PSAO through various functions, including but not limited to providing day-to-day management ... fulfillment and heat zones. + Oversees new pharmacy credentialing and enrollment. ** PBM /Payor Contracting and Audit Team** + Provides oversight of daily activities… more
- KPH Healthcare Services, Inc. (East Syracuse, NY)
- …position or similar + Preferred: minimum of 1 year in a pharmacy benefit manager ( PBM ) setting with working knowledge of operations. **Special Conditions of ... **Overview** **Scope of Responsibilities:** Assist with regulatory and compliance matters within ProAct. **Job Summary:** Responsible for administrative tasks to… more
- BlueCross BlueShield of North Carolina (NC)
- …and tactical aspects of all Medicare related pharmacy benefit management ( PBM ) activities, new initiatives, and other ongoing business deliverables in accordance ... with business needs. Identifies, evaluates, and resolves issues with PBM related deliverables. Resolves issues by utilizing facts, knowledge, and experience to steer… more
- BrightSpring Health Services (Morton Grove, IL)
- … Manager will also provide educational materials to facilitate compliance with procedures, tools, and resources* Works with other disciplines (credit/collections, ... Quarterly Business Reviews and Pharmacy Optimization Services* The Corporate Account Manager owns client issue escalation and resolution process. Working directly… more
- Sanofi Group (Cambridge, MA)
- …while helping to make an impact on millions around the world. As ** Manager , Contract Development** within our Contract Development and Administration team, you'll be ... analysis to evaluate pricing proposals by Account Management and/or PBM /Payer Customers and provide financial and strategic recommendations/solutions for… more
- Children's Hospital & Research Center Oakland (Oakland, CA)
- …the following areas: hospital operations, pharmacy operations, pharmacy benefit manager ( PBM ), retail pharmacy, and/or pharmaceutical manufacturer. **Additional ... **Job Purpose Statement:** The Senior Pharmacy Compliance Analyst (SPCA) is responsible for the review...responsible for the review and evaluation of healthcare regulatory compliance controls and programs. Develops regulatory policies and systems… more
- CVS Health (Columbus, OH)
- …of appeal related issues and resolving them under tight TATs to remain in compliance . The Manager , Pricing is also responsible for creating reports required to ... care more personal, convenient and affordable. **Position Summary** The Manager , Pricing must have expertise and knowledge of the...monitor appeal bill compliance , satisfying client reporting requirements for appeals, as well… more
- The Cigna Group (Bloomfield, CT)
- …managing client facing products, broad-based knowledge of Regulated Markets/Pharmacy Benefit Manager ( PBM ) operations, experience leading people, a strategic ... to influence and drive change. This position will ensure compliance with the Center for Medicare and Medicaid Services...into actions/requirements + Successful track record as a people manager and/or possesses clear aptitude as a leader +… more
- Prime Therapeutics (Columbus, OH)
- …passion and drives every decision we make. **Job Posting Title** Provider Relations Manager - Remote **Job Description** The Manager Provider Relations is ... and efficiency of customer service to members, providers and clients. The Manager of Provider Relations works in collaboration with leaders throughout the… more
- CVS Health (Phoenix, AZ)
- …office suite. **Preferred Qualifications** + Healthcare experience. + Pharmacy Benefit Manager ( PBM ) experience. **Education** + Bachelor's degree required, may ... to make health care more personal, convenient and affordable. **Brief Overview** As a Manager , Investigations - FEP MQA for CVS Health, you will Manage and optimize… more
- Novo Nordisk (Plainsboro, NJ)
- …and hormone therapy products. Relationships The position reports to a Senior Manager , an Associate Director, or a Director in Strategic Pricing and Contracting. ... and Innovation + Identifies opportunities for account profitability optimization within a PBM /GPO and works in collaboration with Market Access Director and Director… more
- Prime Therapeutics (Columbus, OH)
- …It fuels our passion and drives every decision we make. **Job Posting Title** Manager , Reporting & Analytics - Remote **Job Description** The Manager , Reporting ... Lead the development of the department reporting strategy based on compliance and regulatory needs, client demands, continuous improvement, and inter-departmental… more
- Veterans Affairs, Veterans Health Administration (Walla Walla, WA)
- …inventory management of drugs, vaccines, and supplies and regulatory and compliance aspects of the pharmacy department including reverse distribution, medication and ... cost containment strategic plan by fully utilizing the VISN and National PBM pharmacoeconomic resources and community by translating national data, innovations, and… more
- CVS Health (Springfield, IL)
- …make health care more personal, convenient and affordable. **Position Summary** As a Manager in the Specialty Contract Management group, you will help grow the ... Specialty drug pricing guarantee management, margin management as well as client contract compliance . In this role you will also be responsible to consult with other… more
- Wolters Kluwer (Indianapolis, IN)
- …Kluwer Health Clinical Effectiveness team** , the Lead **Technology Product Manager ** **- Commercial Drug Information** role for **Medi-Span** represents the voice ... matter experts, engineering and sales to define segment-specific (eg Payer, PBM , Life Sciences, etc.) product strategies + Curate relationships with customers… more
- Medical Mutual of Ohio (OH)
- …. Assures compliance with contractual requirements of Pharmacy Benefit Manager ( PBM ) vendor for processing of pharmacy claims, accumulator transfers, ... data services and/or systems in a health plan or PBM , or equivalent experience in healthcare or financial services....including membership and claims, with a prescription drug management ( PBM ) company. . Knowledge of PBM benefits… more