- Blue Cross Blue Shield of Massachusetts (Hingham, MA)
- …Medical Policy Criteria + Review and interpret member's eligibility, claim history, and Pharmacy Program information using the PBM claims software to provide ... calls. + Process pharmacy authorizations utilizing PBM real time on line claims adjudication software. + Support new clinical program implementation + Serve as a… more
- Prime Therapeutics (Boston, MA)
- …/ scrum leading experience + PBM experience or experience working with medical claims , pharmacy claims , healthcare and/or benefits data + Experience ... partnerships with various levels of leadership within the organization, acting as a representative of the broader Reporting and Analytics team + Coach and provide… more