- Prime Therapeutics (Boston, MA)
- …fuels our passion and drives every decision we make. **Job Posting Title** Pharmacy Network Manager - Remote **Job Description** The Pharmacy ... regulated industry; including 3 years of managed care experience in medical or pharmacy network contracting + Must be eligible to work in the United States… more
- Prime Therapeutics (Boston, MA)
- …specifications. The position coordinates and provides educational assistance to network providers regarding pharmacy reimbursement, provides liaison services ... decision we make. **Job Posting Title** Maximum Allowable Cost Programs Specialist - Remote **Job Description Summary** The purpose of this position is to ensure… more
- WTW (Boston, MA)
- …+ Understanding of health plan utilization/case management processes, network management, credentialing, quality management, pharmacy prior-authorization ... data requests on behalf of each client/carrier + Coordinate with Project Manager regarding sending requests, timing, status, and follow-up + Attend internal and… more
- WTW (Boston, MA)
- …+ Understanding of health plan utilization/case management processes, network management, credentialing, quality management, pharmacy prior-authorization ... portion of parity assessment, including: + Complete reviews of medical and pharmacy documentation illustrating compliance with MHPAEA + Coordinate with Project … more
- Takeda Pharmaceuticals (Boston, MA)
- …is true to the best of my knowledge. **Job Description** The Key Account Manager (KAM) is the liaison between Takeda and strategic prioritized National and Regional ... within the assigned customer segment, which may be Medical Policy, Operations, Pharmacy , Practice Guideline and Clinical decision makers, as well as any critical… more
- AmeriHealth Caritas (Manchester, NH)
- …integrated managed care products, pharmaceutical benefit management and specialty pharmacy services, behavioral health services, and other administrative services. ... + Identifying and implementing evidence-based practice guidelines throughout the provider network . + Overseeing the quality of clinical care for network… more
- Elevance Health (Woburn, MA)
- …Payment Integrity line of business** _Location: This position will work a hybrid model ( remote and office). The ideal candidate will live within 50 miles from one of ... data and claim systems for review of facility, professional and pharmacy claims. + Responsible for independently identifying and developing enterprise-wide specific… more