- 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
- Access Dubuque (Dubuque, IA)
- …**About the Company** **Company Information** MedOne is a full-service pharmacy benefit manager ( PBM ), serving clients and members nationwide. With a fully ... Implementation & Project Manager **MedOne Pharmacy Benefit Solutions** 1 Positions ID:...drives solutioning and deployment. + Manages implementation projects in compliance with client service agreements to eliminate risks for… 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
- CVS Health (Scottsdale, AZ)
- …are seeking a dynamic and experienced leader to join our team as a Senior Manager , overseeing a team of 10 auditors. This role is pivotal in conducting and building ... Medicare Pharmacy Audit programs for our PBM clients. The ideal candidate will be passionate about...the unique needs of our clients. As the Senior Manager , you will be responsible for developing and implementing… 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
- CVS Health (Scottsdale, AZ)
- …and affordable. **Position Summary** Join our dynamic Pharmacy Audit group as the Senior Manager of Pharmacy Post Audit, where you will lead a dedicated team that ... services, and more. This role is pivotal in ensuring compliance with state pharmacy audit laws and involves leading...pharmacies, and prepare internal post-audit reports. As the Senior Manager , you will oversee processes to track, monitor, and… 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
- The Cigna Group (St. Louis, MO)
- **Description of Position:** + The Product Management Senior Manager of Regulated Markets Audit is responsible for leading a team that serves as the Regulated ... and skilled in project management. This position will ensure compliance with the Center for Medicare and Medicaid Services...Regulated Market audits + Work cross functionally across the PBM in support of Regulated Market Audits and serve… more
- CVS Health (Scottsdale, AZ)
- …personal, convenient and affordable. **Position Summary** As a Pharmacy Audit Senior Manager , you will lead a dynamic, multifaceted experienced team to represent the ... + Oversee departmental claim adjustments and finances, ensuring accuracy and compliance with policies and regulations. + Communicate complex concepts to a… more
- CVS Health (Scottsdale, AZ)
- …**Description** This is a Technical and Leadership position in CVS Health's PBM Division. The role requires knowledge of planning and execution of End-to-End ... and scheduling of ETE testing of new business implementation on CVS Health PBM . Review test environment capabilities, identify gaps and engage IT to build those… more
- The Cigna Group (Morris Plains, NJ)
- …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 (Eagan, MN)
- …It fuels our passion and drives every decision we make. **Job Posting Title** IT Manager - Data User Experience **Job Description** The Manager IT is responsible ... management, coordination, capacity tracking of assigned resources for their team. The Manager promotes Employee engagement. This role is responsible for working in… more
- CVS Health (Mount Prospect, IL)
- …care more personal, convenient and affordable. **A Brief Overview** Pharmacy Operations Manager , will be responsible for the maintenance and uptime of the Automation ... to restore machinery to satisfactory operating conditions. + Ensures safety and compliance in the work environment by eliminating potential equipment safety hazards… more
- Prime Therapeutics (Columbus, OH)
- …our passion and drives every decision we make. **Job Posting Title** Employer Account Manager - Remote **Job Description** The Account Manager is responsible for ... at all levels within an organization + Ability to balance and prioritize compliance , business and other competing goals and risks, while still driving programs and… more
- CVS Health (Richardson, TX)
- …knowing you are helping many people each day. The IT Development Senior Manager position exists to successfully execute projects / initiatives in an information ... and take action on time sheets for CVS and vendor resource to ensure compliance . + You will actively participate in recruitment and selection processes for both CVS… more
- Prime Therapeutics (Eagan, MN)
- …Reports to a Functional Business Owner, Manager or Director in PBM Operations, Specialty Operations, Clinical Operations, Compliance , Finance or Supply Chain ... level of understanding of the accounting and financial ecosystem supporting the PBM business. This position will represent the finance and accounting functions with… more
- BrightSpring Health Services (Tempe, AZ)
- …for network devices and connectivity according to industry best practices & HIPAA compliance . Works with the Manager of Enterprise Architecture, the Security ... you. Please apply today! Responsibilities + Works with the Manager of Enterprise Architecture, other associates, and vendors in...Office and HIPAA Compliance department in defining & implementing security standards +… more
- The Cigna Group (Houston, TX)
- …actuarial analytics support within the regulated Medicare market and Pharmacy Benefit Manager ( PBM ) Healthplan space. The Actuarial Strategy role is designed ... + Regulated Markets Medicare Part D Experience Pharmacy Benefit Manager ( PBM ) / Healthcare / pharmaceutical experience...Bid Development, Desk Review & Audits + CMS Regulatory Compliance / Reporting + Financial Reconciliation Modeling + Trend… more