- Intermountain Health (Murray, UT)
- **Job Description:** Join Scripius, a rapidly growing and innovative PBM subsidiary of Select Health Scripius is a full service transparent PBM that is ... to oversee the creation of marketing brochures and member communications . It ensures the end products portray the expected...to innovate and push ideas to change the current PBM landscape. We need people that are skilled technical… more
- BrightSpring Health Services (Englewood, CO)
- …and healthcare professionals. Providing service to all the Amerita locations, the PBM Payer Audit Specialist reviews audit request, compiles and classifies ... identifies documentation needed to respond effectively and efficiently. The PBM Payer Audit Specialist also performs quality...to type 40+ WPM. + Strong verbal and written communication skills with the ability to independently obtain and… more
- Molina Healthcare (Covington, KY)
- **Molina Healthcare** is hiring for a remote **Pharmacy Operations Specialist ** This role can be worked remotely anywhere within the US. This role will be the ... is fast paced, requiring attention to detail, analysis and excellent communication . **HIGHLY QUALIFIED APPLICANTS WILL HAVE THE FOLLOWING:** + Pharmacy Technician… more
- Novant Health (Winston Salem, NC)
- **Overview** **NOVANT CORPORATE PHARMACY** **PHARMACY BENEFITS SPECIALIST ** Novant Health is an integrated system of physician practices, hospitals, outpatient ... their journey to health and wellness. The Pharmacy Benefits Specialist at Novant Health works closely with the Pharmacy...Novant Health works closely with the Pharmacy Benefits Manager ( PBM ), Benefits Consultant(s), and the People and Culture team… more
- St. Luke's Health System (Boise, ID)
- …are looking for an RN Quality Specialist to join our Patient Blood Management ( PBM ) program, under the leadership of the PBM Quality RN Manager. Are you an ... this may be the role for you! St. Luke's Patient Blood Management ( PBM ) is an interdisciplinary, patient-centered program for optimizing patient Blood Health through… more
- Adecco US, Inc. (Cambridge, MA)
- …process that requires a high level of organization and strong communication skills. The Reimbursement Support Specialist follows standardized workflows ... Healthcare & Life Sciences is hiring a contract hybrid Reimbursement Resource Specialist for our Pharmaceutical partner in Cambridge, MA. The anticipated hourly wage… more
- KPH Healthcare Services, Inc. (Gouverneur, NY)
- …for the entry of new client data or changes to existing clients into the PBM adjudication platform. Translates client benefit needs into the PBM platform and all ... our formulary and benefit configurations as designated by BOM, via approved communication channels such as Clinical, Pricing, Benefit Review Team, Eligibility, and… more
- US Tech Solutions (RI)
- **Job Title: Prior Authorization Specialist ** **Location: Fully remote** **Duration: 12 months contract** **Job Description:** + Prior Authorization Specialist ... standards + Conveying resolution to beneficiary or provider via direct communication and professional correspondence + Acquiring and maintaining basic knowledge of… more
- Prime Therapeutics (Eagan, MN)
- …our passion and drives every decision we make. **Job Posting Title** Claims Specialist - Hybrid **Job Description** The Claims Specialist is responsible for ... with Microsoft Office products + Strong written and verbal communication skills + Strong organizational skills + Ability to...+ Reports to a Supervisor or Manager in the PBM Operations department Potential pay for this position ranges… more
- Capgemini (El Paso, TX)
- …and determine coverage, determination and appeals process *Good written and verbal communication skills *The ability to display soft skills while moving the call ... standards *Conveying resolution to beneficiary or provider via direct communication and professional correspondence *Acquiring and maintaining basic knowledge of… more
- Sharp HealthCare (San Diego, CA)
- …prior authorization process setting. Or 3 Years experience with managed care, PBM , Medicare Part D, Medicaid, or Commercial Health Insurance. + California Pharmacy ... specifically relating to drug utilization and reimbursement trends. + Communication and TeamworkConsistently demonstrates self-motivation, cooperation, teamwork, initiative and… more
- US Tech Solutions (May, OK)
- …standards + Conveying resolution to beneficiary or provider via direct communication and professional correspondence + Acquiring and maintaining basic knowledge of ... of information being provided to internal and external customers. + Communication with other internal groups regarding determination status and results (seniors,… more
- KPH Healthcare Services, Inc. (Gouverneur, NY)
- …preparation and the distribution of monthly, quarterly, and annual management reports for PBM clients, and from our Claims Processor. + Assist with on-site client ... Exceptional phone and listening skills. + Exceptional written and verbal communication skills + Preferred PC skills including Microsoft Office **Attendance… more
- Molina Healthcare (Louisville, KY)
- **Molina Health** care is hiring for a remote **Pharmacy Operations Specialist ** This role can be worked remotely anywhere within the US. This role will be the ... is fast paced, requiring attention to detail, analysis, and excellent communication . **Job Summary** Molina Pharmacy Services/Management staff work to ensure that… more
- Blue Cross Blue Shield of Massachusetts (Boston, MA)
- …In addition to account underwriting responsibilities, the Underwriter / Pharmacy Specialist will have opportunities to participate in project teams working to ... efforts. + Act as Liaison between Underwriting Department and our PBM developing working relationships that drive partnership and accountability. + Act… more
- AbbVie (North Chicago, IL)
- …is a subject matter expert in all aspects of the Patient Access Specialist role including patient and HCP communication , insurance investigation, payer calls, ... Services provides leadership, support and supervision for the Patient Access Specialist team with the Patient Assistance Program (PAP) within Pharmacy Solutions.… more
- Prime Therapeutics (Columbus, OH)
- …related to business requirements + Route new and updated responses to Database Specialist for inclusion in the RFP content management system + Other duties as ... assigned **Minimum Qualifications** + Bachelor's degree in English, Journalism, Marketing, Communications , or related area of study, or equivalent combination of… more
- BrightSpring Health Services (Englewood, CO)
- …to determine appropriate drug, make recommendations for medical billing or PBM billing, review insurance-based formulary. They will also interpret, clarify, verify, ... to provide clinical and technical support as needed + Documents all communication with physicians, nurses, other members of the healthcare team and… more