- 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 ... and guidance to team members and serves as an expert for the team. + May support review and...years of experience leading and managing Pharmacy Benefit Manager / PBM end-to-end testing for web and mainframe-based applications, including… more
- University of Utah Health (Salt Lake City, UT)
- …curriculum. + Coordinates system-level transfusion and blood management governance. + Provides expert PBM consultation and advice to sponsors, champions, and ... statistics. + Collaborates with sibling departments to execute system level process improvement. + Monitors PBM program performance, established metrics,… 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. ... on member experience. Conducts outreach to Pharmacy Benefit Manager ( PBM ) for refills, claim reprocessing and to members to...needed. . Assists more junior level with any oversight process questions. . Performs other duties as assigned. **Senior… more
- HCA Healthcare (Nashville, TN)
- …and other leaders** **What you will do in this role includes:** + Serve as PBM and HealthTrust program expert to external constituents in the corporate segment ... in the corporate sector, with intimate knowledge of the process and procedures used to govern PBM selection + Deep experience working with Human Resources buyers… more
- HCA Healthcare (Nashville, TN)
- …sales process , CRM applications, reporting, and forecasting. + Serve as PBM and HealthTrust Program expert to external constituents. + Be consistently ... the continued growth of the HealthTrust Pharmacy Benefit Management ( PBM ) Program including leading a team of individuals in...strategic leadership to support the expansion of the HealthTrust PBM Program. **What you will do in this role… more
- CVS Health (Austin, TX)
- …Clinical and Benefit Organization, with particular emphasis on solving problems, process improvement and increase automation opportunity within testing team. You ... will have the opportunity to utilize your PBM technical skills and logical skills to analyze the...technical skills and logical skills to analyze the business process , insert technology to solve problems and improve efficiency… more
- Prime Therapeutics (Columbus, OH)
- …to a variety of complex problems + Drive enterprise-wide transformation and process improvement to financial pricing analytics processes and programs + Other duties ... financial analysis to include 5 years of experience in Pharmacy Benefit Management ( PBM ), claims processing, healthcare, and/or related field + 3 years of experience… more
- Mount Sinai Health System (New York, NY)
- …Program Director serves as the primary pharmacy benefits subject matter expert supporting Mount Sinai Health System. **Qualifications** + Registered Pharmacist ... processes needed to support clients. + Operational understanding and competence with PBM business models. + Understanding of the financial and pricing strategies of… more
- Omnicell (Grapevine, TX)
- …fulfillment and heat zones. + Oversees new pharmacy credentialing and enrollment. ** PBM /Payor Contracting and Audit Team** + Provides oversight of daily activities ... to manage new payor and PBM contracts, including strategies to ensure physician referrals can...management. + Appraises subordinate performance through a formal review process on a quarterly basis as designated by Human… more
- Prime Therapeutics (Columbus, OH)
- …where the position is located + 7 years of related work experience in Trade/Rebates, PBM healthcare or insurance + Must be eligible to work in the United States ... required + 10 years of related work experience Trade/Rebates, PBM healthcare or insurance + Must be eligible to...build relationships at all levels within an organization + Expert negotiation and influencing skills + Proven financial analysis… more
- Prime Therapeutics (Columbus, OH)
- …clear, accurate and effective executive reports + Serves as subject matter expert within Compliance and develops solutions to highly complex compliance problems by ... periodic reports related to licensed functions (Pharmacy Benefit Management ( PBM ), Third Party Administrator, Utilization Review Organization, Business, State… more
- Veterans Affairs, Veterans Health Administration (West Haven, CT)
- …orally and in writing to persuade and influence clinical and management Expert understanding of regulatory and quality standards for their program area. Ability ... to maximize outcomes in their program area or area of clinical expertise. Expert knowledge of a specialized area of clinical pharmacy practice or specialty area… more
- The Cigna Group (St. Louis, MO)
- …in St. Louis, MO_** **POSITION SUMMARY** The successful candidate will become an expert in the setup, payment, tracking and reporting of financial and rebate ... guarantees in accordance with Express Script's PBM client contracts. Collaboration with cross-functional teams will be...of client clinical rules impacting rebate eligible products. + Expert in addressing service requests from the Account Team… more
- Veterans Affairs, Veterans Health Administration (Reno, NV)
- …decision to outsource CSP preparations or to prepare CSP's locally follows the VHA PBM decision making hierarchy and associated guidance and assures PBM 's CSP ... Selected applicants will be required to complete an online onboarding process . Must pass pre-employment physical examination. Participation in the seasonal influenza… more
- Veterans Affairs, Veterans Health Administration (North Chicago, IL)
- …Policies, and Handbooks relating to CSPs, VHA Pharmacy Benefits Management ( PBM ) Guidance for CSPs, Guidelines for Safe Preparation of Sterile Compounding ... or to prepare CSPs in the medical facility pharmacy follows the VHA PBM decision-making hierarchy Ensures the competency of Pharmacy personnel in the preparation and… more
- The Cigna Group (St. Louis, MO)
- …organizational, administrative, and analytical skills to make a positive impact in the PBM Health Plan Clinical Team, while expanding their knowledge of the health ... industry. This position aids and supports the delivery of clinical strategy for the PBM Health Plan Clinical Team. The Strategic Planning Advisor provides expert … more
- Pfizer (Groton, CT)
- …using batch and continuous processes. This team is seeking a (postgraduate level) expert process modeler to develop new computational tools and system level ... **ROLE SUMMARY** The drug-product process -modeling team in Drug Product Design (DPD) has...process models and flowsheets, statistical techniques, population-balance models ( PBM ), discrete element method (DEM), computational fluid dynamics (CFD)… more
- The Cigna Group (Bloomfield, CT)
- …Senior Advisor will be required to gain in-depth knowledge of the PBM Industry and ESI-specific pricing methods. The Risk and Underwriting Senior Advisor ... by ESI's Pricing Governance Team. **ESSENTIAL FUNCTIONS** + Provides expert content/professional leadership on complex Risk & Underwriting assignments/projects. +… more
- Elevance Health (Columbus, OH)
- …effectively. + During practice-level discussions, act as a subject matter expert in pharmacy-related clinical measures for value-based care agreements. + Work ... + Minimum of 2 years of managed care pharmacy ( PBM ) experience or residency in lieu of work experience;...onsite will be discussed as part of the hiring process . Candidates must reside within 50 miles or 1-hour… more
- Prime Therapeutics (Columbus, OH)
- …and across the organization. **Responsibilities** + Collaborate as a subject matter expert (SME) with underwriters, other areas of Prime, and senior management on ... initiatives, data analyses, and the Request For Proposal (RFP) process + Lead, manage, and review data analyses, reporting,...to include 6 years in a healthcare organization or PBM + Actuarial designation (ASA or FSA) + Must… more