- Cambia Health Solutions, Inc (Lake Oswego, OR)
- …of end-to-end assumptions and refinement of data/modeling capabilities across the Health Plan and Pharmacy Benefit Manager ( PBM ). - all in service of creating an ... end-to-end assumptions and data/modeling capabilities across the Health Plan and Pharmacy Benefit Manager ( PBM )? Then this role may be the perfect fit. What You… more
- Merck & Co. (North Wales, PA)
- …strategies and promotional initiatives for US payer customer segments (health plan, PBM , Medicaid, Medicare, federal, pharmacy and hospital) to achieve market ... access goalsLead coordination and engagement efforts with members of the Integrated Account Management organization, including point team and customer-facing account executives and account directorsPartner with the assigned promotions manager(s) to develop… more
- Segal (Washington, DC)
- …advice that improves lives? Are you inspired by solving for mysteries in pharmacy benefits data? This opportunity may be for you!Our Senior Consultant, Pharmacy ... capital development and revenue generating innovation initiatives in the healthcare/ pharmacy benefits industry. The Senior Consultant actively contributes to a… more
- The Cigna Group (St. Louis, MO)
- **B2B Growth Marketing Senior Advisor - Pharmacy Benefits Management ( PBM ) - Hybrid** **JOB DESCRIPTION** The job profile for this position is Segment Marketing ... cross-sell marketing programs and campaigns for Express Scripts, the Pharmacy Benefit's Management ( PBM ) line of business. The ideal candidate will work closely… more
- US Tech Solutions (May, OK)
- …based on prior authorization as per policy and procedure. **Experience:** + Previous pharmacy experience in PBM ( Pharmacy Benefits Management) required. + ... that experience are preferred. **Skills:** + Prior authorization + PBM **Education:** + Bachelor's degree in pharmacy or Pharm D. Must have an active license in… more
- Fairview Health Services (Minneapolis, MN)
- …safety; development and implementation of pharmacy network design and management, pharmacy and PBM vendor contracting and relations; pharmacy information ... + Lead cross-functionality across business units to develop and manage pharmacy and PBM vendor contracting and management efforts to achieve quality, positive… more
- BlueCross BlueShield of North Carolina (NC)
- …and manages the day-to-day operational and tactical aspects of all Medicare related PBM ( Pharmacy Benefit Manager) activities, new initiatives, and other ongoing ... business needs. Identifies, evaluates, and resolves issues that conflict with PBM related deliverables. Collaborates closely with project team members, business… more
- Highmark Health (Wexford, PA)
- …for all preauthorization entries into applicable databases (ie internal medical claims systems, PBM pharmacy systems) to ensure swift and appropriate payment of ... Coordinates and administers the effective and efficient processing of the pharmacy benefits prior authorization process, ensuring that pharmacy benefits… more
- Elevance Health (Altamonte Springs, FL)
- … Pharmacy ** is responsible for accurate and prompt credentialing for health plans and pharmacy benefit managers ( PBM ) for all pharmacy sites. **How you ... **Be Part of an Extraordinary Team** _BioPlus Specialty Pharmacy is now part of CarelonRx (formerly IngenioRx), and a proud member of the Elevance Health family of… more
- CVS Health (Northbrook, IL)
- …convenient and affordable. Position Summary CVS Health is working to transform Pharmacy Benefit Management ( PBM ) Client Reporting into a strategic capability, ... and enhanced client satisfaction. We are looking for a PBM Client Reporting Product Manager to help define the...go-to-market strategies and product positioning + Align accomplishments to PBM Client Reporting OKR's and provide regular updates on… more
- CVS Health (Scottsdale, AZ)
- …create new tools and reports while maintaining an in depth understanding of the PBM and enterprise pharmacy environment. The Analyst interfaces with and manages ... make health care more personal, convenient and affordable. Position Summary The Pharmacy Quality Control Analyst position is responsible for the timely and accurate… more
- UCLA Health (Los Angeles, CA)
- …Officer of Medicare Advantage, you'll spearhead the development and oversight of our pharmacy benefit management ( PBM ) business unit. In this pivotal role, ... of implementing innovative programs aligned with strategic objectives + Knowledgeable in PBM third-party billing, pharmacy claims processing, and pharmacy … more
- HUB International (Albuquerque, NM)
- …preferred + 3+ years of financial, clinical or strategic advising in the pharmacy benefit manager ( PBM ) marketplace with established relationships with PBM ... As part of our National Pharmacy Practice, the Region Pharmacy Consultant...the HUB analytics platform along with various partners and PBM 's decision support tools to justify the election of… more
- BrightSpring Health Services (Morton Grove, IL)
- …Responsibilities + Enter, access, and verify the accuracy of data in the pharmacy and PBM systems. + Establish and maintain patient profiles, including ... OnePoint Patient Care is the nation's leading independent provider of community-based hospice pharmacy and pharmacy benefits management ( PBM ) services -… more
- Molina Healthcare (KY)
- …changes + Liaison with Member and Provider Service Teams for both Molina and PBM + Maintain Pharmacy SharePoint and provide direction for website + Develop ... **REQUIRED EXPERIENCE/KNOWLEDGE, SKILLS & ABILITIES** : + 5+ years Managed Care, Pharmacy or PBM experience. + Able to present ideas and information concisely to… more
- Prime Therapeutics (Columbus, OH)
- …years of work experience in retail, long term care, specialty, home infusion, or mail order pharmacy or combined pharmacy and PBM experience to include: + 2 ... every decision we make. **Job Posting Title** 340B Onsite Pharmacy Auditor - Remote in the Florida market **Job...in the state where position is located + Previous PBM experience **Minimum Physical Job Requirements** + Ability to… more
- G-TECH Services, Inc. (Detroit, MI)
- Responsibilities/Tasks * Assist with all functions related to Pharmacy Benefit Manager ( PBM ) oversight for Medicare Advantage Part D plans. * Receive and respond ... 3 Required Skills/Experience - The most important must-have skills. * Retail Pharmacy , Healthplan, PBM or related experience - at least 2 years * Strong computer… more
- CVS Health (Phoenix, AZ)
- …of experience in healthcare industryPreferred Qualifications 2+ years' experience with PBM or Specialty Pharmacy /Home Infusion industry preferred.* Previous ... include retail network, mail order, specialty, and pharmaceutical manufacturer rebates for PBM client contracts. Some of your key responsibilities will include: -… more
- Elevance Health (Denver, CO)
- …and experience which would provide an equivalent background. **Preferred Qualifications:** + Pharmacy Claims Audit Strongly preferred + PBM ( Pharmacy ... preferred + Experience working in an Agile environment strongly preferred + PBM ( Pharmacy Benefit Management) Benefits experience preferred + Healthcare… more
- CVS Health (Chicago, IL)
- …team and will focus on building & deploying analytic models that help the PBM business meet its client and pharmacy financial guarantees. This team works ... to meet financial guarantees contracted by Caremark with its clients and pharmacy partners by optimizing drug prices while adhering to several regulatory and… more
