- CVS Health (Chicago, IL)
- …has an exciting opportunity to join our PBM Finance Enablement team as a Manager , Compliance Pharmacy Payments within the PBM Reporting team. CVS Health ... exciting opportunity to join our PBM Finance Enablement team as a Manager , Compliance Pharmacy Payments within the PBM Reporting team. CVS Health strives… more
- Elevance Health (Wallingford, CT)
- …and improved overall health outcomes by putting the patient first._ **Title** : PBM Pricing Strategy Analyst Manager **Location:** Candidates must reside within ... 108 LEIGUS RD** **Build the Possibilities. Make an Extraordinary Impact.** The ** PBM Pricing Strategy Analyst Manager ** is responsible for Pharmacy Services… more
- System One (Baltimore, MD)
- …company. This role requires deep expertise in pharmacy supply chain financial management, PBM transitions, and pharmacy operations. The Program Manager will lead ... Job Title: Pharmacy Benefits Program Manager Client: Health Insurance Organization Location: Baltimore, MD...a major pharmacy supply chain implementation and PBM transition, overseeing execution activities, stakeholder alignment, contract and… more
- Boehringer Ingelheim (Ridgefield, CT)
- …as applicable, and to provide support to the Associate Director, Contract Compliance by: developing a comprehensive discount accrual forecasts and by providing ... individual will provide support to the Associate Director, Contract Compliance and the Director of Contract Development, as applicable,...in the pharmaceutical or related industry, or with a PBM , Wholesaler or Covered Entity with and at least… more
- Prime Therapeutics (Columbus, OH)
- …Posting Title** Manager , Compliance - Remote **Job Description** The Compliance Manager works closely with designated business areas, Legal, and other ... changing laws and regulations, accreditation standards, and client contractual compliance obligations, interpret the impact, and manage solutions for designated… more
- The Cigna Group (Denver, CO)
- **SOC 1 Compliance and Delivery Manager ** This is a senior, individual contributor role **Job Description:** This is a global role focused on leading SOC1 ... for System and Organization Controls (SOC1) Reports. The SOC1 Compliance and Delivery Manager will collaborate with...SOC2 and SOX + Experience in auditing pharmacy benefit manager ( PBM ) and corporate functions preferred +… more
- CVS Health (Columbus, OH)
- …do it all with heart, each and every day. **Position Summary** The ** PBM Data Analyst** performs prescription claim and accumulator audits, verifies policy coverage, ... assesses claim validity, and communicates with PBM ( _Pharmacy Benefit Manager_ ) vendors & client...overages. + Maintains electronic records, updates information, and ensures compliance with relevant policies and regulations. + Assists with… more
- KPH Healthcare Services, Inc. (East Syracuse, NY)
- …position or similar + Preferred: minimum of 1 year in a pharmacy benefit manager ( PBM ) setting with working knowledge of operations. **Special Conditions of ... **Overview** **Scope of Responsibilities:** Assist with regulatory and compliance matters within ProAct. **Job Summary:** Responsible for administrative tasks to… more
- VNS Health (Manhattan, NY)
- …Drug Event Reports and sees that staff, other MA/PD plans, and Pharmacy Benefit Manager ( PBM ) work to resolve edits and errors. Identifies, tracks and trends ... of data transfers. Monitors enrollment processing activities to ensure compliance to Center for Medicare and Medicaid Services (CMS)...issues and alerts PBM as necessary, assist with finding resolutions as deemed… more
- Highmark Health (Columbus, OH)
- …or CERTIFICATIONS** **Required** + 5 years in a Health Plan or Pharmacy Benefit Manager ( PBM ) + 3 years of leading healthcare program or product development ... A proven ability to navigate complex regulatory landscapes (including CMS compliance ) and a comfort level tackling ambiguous, high-stakes challenges is crucial… more
- Prime Therapeutics (Columbus, OH)
- … compliance or operations related roles in the healthcare or Pharmacy Benefit Manager ( PBM ) industry + 1 year of leadership/people management experience + ... It fuels our passion and drives every decision we make. **Job Posting Title** Manager , Client Audit Services - Remote **Job Description** The Manager Client… more
- Omnicell (Plano, TX)
- …operations and improve patient outcomes. We are seeking a dynamic Project Manager to join our collaborative Project Management Office (PMO) and drive impactful ... business projects. As a Project Manager within our PMO, you will play a pivotal...specifications, technical designs, test plans, and change logs, ensuring compliance with organizational standards and regulatory requirements. * Report… more
- CVS Health (Columbus, OH)
- …we do it all with heart, each and every day. **Position Summary** The Senior Manager , Pricing will lead a team of 20+ colleagues in the management of pharmacy ... internal business units to resolve issues quickly. The Senior Manager , Pricing is also responsible for working legal and..., Pricing is also responsible for working legal and compliance team to ensure state regulatory update are operationalized.… more
- The Cigna Group (Honolulu, HI)
- **POSITION SUMMARY** Staff Pharmacist, Sr. Manager , Pharmacist In-Charge (PIC) Responsible for the management and performance of clinical pharmacy fulfillment ... in the process development + Align and work with manager on the strategic direction of pharmacy operations +...Keep current on industry trends and regulations and ensure compliance . May hold license for the pharmacy. May represent… more
- CVS Health (Scottsdale, AZ)
- …every day. **Position Summary** As the Medicare Pharmacy Audit Programs Project Manager you will be responsible for administering Medicare Part-D Pharmacy Audit ... skills to make business-critical decisions and develop strategies to maximize client compliance integrity. You will utilize a wide variety of skills and… more
- The Cigna Group (St. Louis, MO)
- **Position Summary:** The Operations Manager is responsible for the day-to-day operations of a Pharmacy fulfillment team, including drug warehouse / inventory, and ... training, and evaluation of staff. + Develop, track, and monitor employee's compliance to safety, quality, service, and production standards. + Monitor prescription… more
- Prime Therapeutics (Columbus, OH)
- …and drives every decision we make. **Job Posting Title** Health Plan Account Manager - REMOTE **Job Description** The Account Manager is responsible for ... at all levels within an organization + Ability to balance and prioritize compliance , business and other competing goals and risks, while still driving programs and… more
- CVS Health (Springfield, IL)
- …submissions, to meet our department goals including regulatory projects to ensure compliance with changing regulations and rules. The ideal candidate must be an ... and ensure regulatory requirements are understood and integrated. As an Implementation Manager , you have end-to-end accountability for the overall delivery of the… more
- AbbVie (Mettawa, IL)
- …maintains reporting to track performance, dashboard metrics, 340B entity eligibility compliance ), (3) manages 340B duplicate discount scrubbing (4) manages Covered ... roster provided to wholesalers + Monitor and track pricing compliance (reconciling to the wholesaler chargebacks) and coordinate with...IQVIA data sources (eg HCOS data), Rx claims data, PBM rebate data. + Knowledge of 340B flows preferred.… more
- CVS Health (Columbus, OH)
- …timely delivery and successful outcomes within the project parameters. + Ensures compliance with regulatory requirements and ethical standards in all analytics work ... project management or similar role **Preferred Qualifications** + Experience within PBM industry + Certified Analytics Professional (CAP) preferred. + Adept at… more