- GEHA (Lee's Summit, MO)
- …by a nimble and efficient organization. The Director of Pharmacy Operations & PBM Management will guide and improve our Federal Employee Health Benefit (FEHB) and ... looking for a strategic Health Plan Pharmacy leader to manage delegated PBM contract oversight (inclusive of utilization and formulary management), oversee clinical… more
- CVS Health (Boston, MA)
- …and every day. **Position Summary** This role is for the **Meritain Health PBM ** ( _Pharmacy Benefit Manager_ ) **Operations Team** and is responsible for processing ... PBM vendor invoices and claims. The ** PBM Invoice Processor** is assigned a set of groups to maintain their invoices on a weekly, bi-weekly, or monthly basis.… more
- CVS Health (Dover, DE)
- …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...any impacted claims. + Communicates with internal partners and PBM vendors, addressing inquiries, resolving issues, and providing accurate… more
- CVS Health (Springfield, IL)
- …of our pricing model. You will be critical to the successful growth of the PBM business as you bring to market vital initiatives focused on meeting the prescription ... Hub areas. **Required Qualifications** + 7+ years of consulting, PBM , or product marketing / product management experience +...managing product go to market campaigns + Experience in PBM pricing or strategy + Understanding of PBM… more
- Elevance Health (Wallingford, CT)
- …improved overall health outcomes by putting the patient first._ **Title** : PBM Pricing Strategy Analyst Manager **Location:** Candidates must reside within 50 miles ... 108 LEIGUS RD** **Build the Possibilities. Make an Extraordinary Impact.** The ** PBM Pricing Strategy Analyst Manager** is responsible for Pharmacy Services pricing… more
- The Cigna Group (Bloomfield, CT)
- …Description Summary:** The Managing Director of the Pharmacy Benefit Management ( PBM ) Customer Service Operations will be responsible for leading and overseeing ... members. This role requires a strategic leader with a deep understanding of PBM operations, exceptional leadership skills, and a passion for enhancing the customer… more
- Premera Blue Cross (Mountlake Terrace, WA)
- …Health Plan Pharmacy leader that will oversee pharmacy clinical operations, PBM relationship, formulary, utilization management, and other pharmacy programs and lead ... Consulting to drive business outcomes. The **Director, Pharmacy Operations & PBM Management** will provide direction and oversight in Premera's Pharmacy strategy,… more
- Prime Therapeutics (Atlanta, GA)
- …passion and drives every decision we make. **Job Posting Title** Business Analyst - PBM PDL - Remote **Job Description** The Business Analyst (BA) will execute on ... Georgia PBM PDL projects as a liaison among business operations,...for work visa or residency sponsorship. **Additional Qualifications** + Pharmacy/ PBM experience + PDL and/or pharmacy rebate experience +… more
- Fairview Health Services (Minneapolis, MN)
- …finished product that supports Clearscript' s strategic efforts to grow and retain key PBM clients. Manage all proposal projects from start to finish and maintain a ... programs and services that are represented in proposals, and the overall PBM industry + Creates process flowcharts, organization charts and graphics as required… more
- US Tech Solutions (May, OK)
- …as per policy and procedure. **Experience:** + Previous pharmacy experience in PBM (Pharmacy Benefits Management) required. + Since the job duties consist of ... candidates with that experience are preferred. **Skills:** + Prior authorization + PBM **Education:** + Bachelor's degree in pharmacy or Pharm D. Must have… more
- CVS Health (Irving, TX)
- …years of contract experience required with a preferred knowledge of PBM business/operations. + Experience in redlining documents. **Preferred Qualifications** + ... Demonstrated ability to manage and organize projects from start to completion + Prior contracting experience in healthcare and knowledge on contracting terminology + Proficiency in Microsoft Word + Proficiency in Microsoft Excel + Ability to work independently… more
- The Cigna Group (Philadelphia, PA)
- …candidate must be able to develop a detailed and strategic understanding of the PBM business model and the various state and federal laws impacting pharmacy networks ... and network management. The position requires an understanding of the health care industry as well as the interpersonal skills necessary to understand and manage complexity, influence business colleagues, foster collaboration and drive results in a fast-paced… more
- Florida Health Care Plans, Inc. (Daytona Beach, FL)
- …configurations, and beneficiary services to government services and beyond. As the PBM Network & Pricing Configuration Analyst, you will be responsible for ... implementing new and updating existing benefit plan setups for Medicare, Commercial, and Employer clients. Also, you will review client configuration requests, identify, and define their needs and requirements, determine the best operational approach, and… more
- BrightSpring Health Services (Louisville, KY)
- Our Company PharMerica Overview Responsible for strategic development and execution of PBM and 3rdParty Payor contracting for PharMerica LTC Pharmacy business units. ... Responsibilities + Oversees all Pharmacy PBM and 3rdParty Payor contracting process for LTC PharMerica...Medicaid. + Manage and negotiate national 3rdParty Payor and PBM contracts to ensure company's objectives are met in… more
- CVS Health (Austin, TX)
- …seeking a highly skilled and experienced individual with a strong background in the PBM industry to join our team as the Lead Director, Rebate Analytics and Client ... employees, including 3 direct reports, dedicated to delivering value to the PBM via rebate guarantee adjustments, conducting client actuals to forecast variance… more
- Walgreens (Deerfield, IL)
- …**Job Responsibilities** + Respond to all levels of inbound Pharmacy Benefit Manager ( PBM ) and major medical insurance related phone calls. + Resolves questions and ... problems submitted by customers and Pharmacy Benefit Manager ( PBM ) following established guidelines and standard SOPs and procedures....to choose the best solution and resolve customer and PBM concerns. + Requests and loads PBM … more
- CVS Health (Springfield, IL)
- …position will be successful through close collaboration with other PBM business functions including consultant relations, competitive intelligence, underwriting, ... sales, PBM operations, and legal. This work requires executive presence,...and complete capture of ALL client commitments as part PBM client renewal / win. Further, collaborate with matrixed… more
- KPH Healthcare Services, Inc. (East Syracuse, NY)
- …serve as legal counsel for ProAct regarding all legal matters related to the PBM industry to include subsidiary pharmacy services. This position will play a pivotal ... + Provide legal support to internal business partners supporting PBM clients + Draft, review and redline a wide...and their counsel to include, but not limited to PBM Services Agreements, Non-Disclosure Agreements and Business Associate Agreements… more
- CVS Health (Charleston, WV)
- …include retail network, mail order, specialty, and pharmaceutical manufacturer rebates for PBM client contracts. Some of your key responsibilities will include: + ... Collaborating with PBM Sales and Account Services to provide recommendations on...+ Developing and maintaining domain expertise across levers of PBM and Enterprise profitability, including retail networks, enterprise dispensing,… more
- The Cigna Group (St. Louis, MO)
- …Scripts seeks an experienced attorney to join the team supporting its PBM Sales and Account Management organization. Duties will consist primarily of counseling ... the organization on legal matters relating to the PBM industry and operations, and negotiating PBM ...the PBM industry and operations, and negotiating PBM agreements between Express Scripts and external clients (health… more
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