- Intermountain Health (Murray, UT)
- …some office time and travel required** Join Scripius, a rapidly growing and innovative PBM subsidiary of Select Health Scripius is a full service transparent PBM ... pharmacies. Ensures coordination and communication of pharmacy benefit management ( PBM ) programs including drug manufacturer contracting, P&T Committee activities,… more
- Elevance Health (Middletown, NY)
- …a 50-mile or 1-hour commute each way of a relevant Elevance Health location. The ** PBM Contract Process Manager** is responsible for managing the life cycle of a ... PBM contract from beginning to completion (RFP through PBM Client Agreement execution), including the contract approval process. **How You Will Make an Impact**… more
- Intermountain Health (Murray, UT)
- **Job Description:** Join Scripius, a rapidly growing and innovative PBM subsidiary of Select Health Scripius is a full service transparent PBM that is ... to innovate and push ideas to change the current PBM landscape. We need people that are skilled technical...skilled technical writers, that have some understanding of the PBM business and who are not afraid to be… more
- Elevance Health (Columbus, OH)
- **JR130960 Business Change Director (Quality Control Test Architect, PBM systems)** CarelonRx's Business Operations org is looking to hire a PBM Test Program ... + 5+ years of experience leading and managing Pharmacy Benefit Manager / PBM end-to-end testing for web and mainframe-based applications, including defining testing… more
- Elevance Health (Mason, OH)
- ** PBM Formulary Analyst II (Business Analyst II)** _Location: This position will work a hybrid model (1-2 days/week in office). The ideal candidate will live within ... a strong, clinical-first lens, to deliver member-centered, lasting pharmacy care. The ** PBM Formulary Analyst II (** **Business Analyst II)** is responsible for… more
- US Tech Solutions (May, OK)
- …as per policy and procedure. **Experience:** + Previous pharmacy experience in PBM (Pharmacy Benefits Management) required. + Since the job duties consist of ... candidates with that experience are preferred. **Skills:** + Prior authorization + PBM **Education:** + Bachelor's degree in pharmacy or Pharm D. Must have… more
- CVS Health (Carson City, NV)
- …**For this role you will need Minimum Requirements** + 5+ years pharmacy, PBM , and/or insurance work experience + Basic awareness of problem solving and ... decision-making skills **Preferred Qualifications** + CPhT **Education** + Bachelor's degree preferred. **Pay Range** The typical pay range for this role is: $46,988.00 - $102,000.00 This pay range represents the base hourly rate or base annual full-time… more
- Northwell Health (New Hyde Park, NY)
- …of relevant experience, required. + Preferred qualification - minimum 3 years of PBM or Health Plan experience Additional Salary Detail** The salary range and/or ... hourly rate listed is a good faith determination of potential base compensation that may be offered to a successful applicant for this position at the time of this job advertisement and may be modified in the future. When determining a team member's base… more
- The Cigna Group (Austin, TX)
- …This position plays a pivotal role in the alignment of business vision, technology strategy and investment portfolio execution in Pharmacy Benefit Services team. This ... team is focused on driving the enterprise strategy to unlock accretive value through Benefit Set Up Transformation and improve operational efficiency. This team will identify horizontal capabilities, align line of business initiatives that move in the… more
- CVS Health (Woonsocket, RI)
- …a Payer Relations Director (PRD) in managing one of the largest and most complex PBM relationships that spans multiple lines of business and has direct ties to a ... targets. You will be involved in aspects of the PBM relationship including, but not limited to, negotiating network...one of the main points of contact for the PBM , acting as the liaison between PBMs and cross-functional… more
- BrightSpring Health Services (Englewood, CO)
- …and healthcare professionals. Providing service to all the Amerita locations, the PBM Payer Audit Specialist reviews audit request, compiles and classifies existing ... and identifies documentation needed to respond effectively and efficiently. The PBM Payer Audit Specialist also performs quality assurance checks for all… more
- HCA Healthcare (Nashville, TN)
- …Sourcing is responsible for managing all aspects of the contract for the HealthTrust PBM Program which has $5.8B in annual spend. The position is responsible for ... managing the master services agreement with the PBM supplier partner and ensuring that all contractual obligations...includes:** + Manage the master services agreement with the PBM supplier partner. + Negotiate terms and conditions of… more
- Medical Mutual of Ohio (OH)
- …review and resolution either directly or forwards/escalates to other departments or PBM . Monitors paid claims for accuracy including for transition supply oversight. ... a strong focus on member experience. Conducts outreach to Pharmacy Benefit Manager ( PBM ) for refills, claim reprocessing and to members to provide status of… more
- Bayer (Little Rock, AR)
- …Accounts will lead customer engagement strategies, manage Regional Payer and PBM customer relationships and deliver profitable access, reimbursement, and appropriate ... of developed plan Ability to navigate deep into the payer/ PBM , manage executive engagements, foster customer touch points within...payer access across regional Payers through alignment of National PBM wins; + Create and co-lead Mission Teams with… more
- CVS Health (Cumberland, RI)
- …Additional CVS office locations may be considered **Position Summary** The Manager of PBM Accounting will assist the Sr Manager in driving an accurate and efficient ... party Eliminations and reconciliations between segments. The Manager of PBM Accounting will also support the Sr. Manager and...the backup to the Senior Manager and Manager of PBM Accounting. The ideal candidate will have a strong… more
- Point32Health (Canton, MA)
- …but are not limited to: a) strategy, negotiation, and administration of PBM (Pharmacy Benefit Manager), specialty pharmacy, medical specialty and medical drug rebate ... organizational strategy. **Key** **Responsibilities/Duties** **- what you will be doing** ** PBM , Specialty Pharmacy and Medical Rebate Contract Strategy and… more
- HCA Healthcare (Nashville, TN)
- …and Qualifications** + **Position is responsible for the continued growth of HealthTrust's PBM program at the center, focused on execution of go to market ... will do in this role includes:** + Serve as PBM and HealthTrust program expert to external constituents in...7 years minimum of previous experience in pharmacy benefits, PBM service HR consulting, business development, sales operations and/or… more
- Molina Healthcare (Covington, KY)
- …and interpret data to identify erroneous execution of the pharmacy benefit by the PBM + Review the daily inventory of "outliers" and remediate as required + Review ... eligibility, claim history, and pharmacy benefit information using the PBM claims software to provide information to both internal...both internal and external clients + Serve as a PBM liaison and other internal teams for real-time support… more
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