- CVS Health (Chicago, IL)
- …every day. **Position Summary** CVS Health has an exciting opportunity to join our PBM Finance Enablement team as a Manager , Compliance Pharmacy Payments within ... CVS Health has an exciting opportunity to join our PBM Finance Enablement team as a Manager , Compliance Pharmacy Payments within the PBM Reporting… 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
- CVS Health (Springfield, IL)
- …we do it all with heart, each and every day. **Position Summary** As a Senior Manager of Product Innovation, you will be part of a team leading the evolution of our ... will be critical to the successful growth of the PBM business as you bring to market vital initiatives...intersection of product development, marketing, and sales. The Senior Manager will also work closely with senior leaders and… more
- Access Dubuque (Dubuque, IA)
- …insights and solutions. **About MedOne:** MedOne is a full-service pharmacy benefit manager ( PBM ), serving clients and members nationwide. With a fully ... **About the Company** **Company Information** MedOne is a full-service pharmacy benefit manager ( PBM ), serving clients and members nationwide. With a fully… more
- CVS Health (Columbus, OH)
- …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 (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...any impacted claims. + Communicates with internal partners and PBM vendors, addressing inquiries, resolving issues, and providing accurate… more
- Elevance Health (Las Vegas, NV)
- …but are not limited to: + Support health plans and the Pharmacy Benefit Manager ( PBM ), ensuring smooth service delivery and adherence to State contracts. + ... lens, to deliver member-centered, lasting pharmacy care. **Title** : Pharmacy Account Manager **Location:** Candidates must reside within 50 miles or 1-hour commute… more
- Walgreens (Deerfield, IL)
- …service. **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. Utilizes all… more
- Access Dubuque (Dubuque, IA)
- …a supportive work environment. **About MedOne:** MedOne is a full-service pharmacy benefit manager ( PBM ), serving clients and members nationwide. With a fully ... **About the Company** **Company Information** MedOne is a full-service pharmacy benefit manager ( PBM ), serving clients and members nationwide. With a fully… 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 ... other market segment support and product teams and pharmacy vendors (including PBM ) + Other duties as assigned or requested. **EDUCATION** **Required** + Bachelor's… more
- Prime Therapeutics (Columbus, OH)
- …legal, 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
- The Cigna Group (Denver, CO)
- …audits such as SOC1, SOC2 and SOX + Experience in auditing pharmacy benefit manager ( PBM ) and corporate functions preferred + Excellent written and verbal ... **SOC 1 Compliance and Delivery Manager ** This is a senior, individual contributor role...Organization Controls (SOC1) Reports. The SOC1 Compliance and Delivery Manager will collaborate with organization-wide Technology teams to drive… more
- Access Dubuque (Dubuque, IA)
- …strategic technical objectives. **About MedOne:** MedOne is a full-service pharmacy benefit manager ( PBM ) dedicated to helping clients and members nationwide ... **About the Company** **Company Information** MedOne is a full-service pharmacy benefit manager ( PBM ), serving clients and members nationwide. With a fully… more
- Access Dubuque (Dubuque, IA)
- …and business partnerships. **About MedOne:** MedOne is a full-service pharmacy benefit manager ( PBM ), serving clients and members nationwide. With a fully ... **About the Company** **Company Information** MedOne is a full-service pharmacy benefit manager ( PBM ), serving clients and members nationwide. With a fully… more
- DOCTORS HEALTHCARE PLANS, INC. (Coral Gables, FL)
- …according to the Medicare Part D defined guidelines + Work with the Pharmacy Benefit Manager ( PBM ) and formulary manager to manage formulary changes and ... new drug reviews and coding to be submitted to the Pharmacy Benefit Manager , New Contract Year formulary evaluation, and rebate strategy evaluation. The Clinical… more
- CVS Health (Scottsdale, AZ)
- …The Implementations Team supports CVS Caremark, the nations leading pharmacy benefit manager ( PBM ). Implementations Managers play a critical role in onboarding ... lines of business and implementing plan changes. Given the complexities of todays PBM landscape, setting up a new client involves managing financial, product, and… more
- Point32Health (Canton, MA)
- …and IMPAC (Integrated Medical Policy Advisory Committee). + Review/edit materials provided by PBM (Pharmacy Benefit Manager ) for presentation of new drugs at P&T ... + Update Preferred Drug List (PDL) annually. + Work with Pharmacy Benefit Manager ( PBM ) to evaluate and select preferred drugs. + For specialty drugs, evaluate… more
- WTW (Milwaukee, WI)
- …benefit plan analysis, design, clinical and cost savings strategies + Pharmacy Benefits Manager ( PBM ) vendor procurement and negotiation + Audits of PBM ... understanding of the pharmacy benefit management and US healthcare ecosystems, either at a PBM , health plan, health tech company or as a benefits consultant + A… more
- Sharp HealthCare (San Diego, CA)
- …+ Medication adjudicationWorks collaboratively with the Sharp Health Plan pharmacy benefits manager ( PBM ) to ensure appropriate adjudication of medications that ... are authorized by Sharp Health Plan.Monitors the PBM adjudication system and identifies discrepancies.Communicates prior authorization decision to medical offices… more
- LA Care Health Plan (Los Angeles, CA)
- …Quality of Care (PQOC) meetings and partner with contracted Pharmacy Benefit Manager ( PBM ) on formulary management requirements to ensure members receive ... and External meetings / workgroups and acts as the PBM point person for Clinical Programs. Assist in auditing...point person for Clinical Programs. Assist in auditing the PBM , subcontracted plans, and medical groups. Perform other duties… more
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