- Elevance Health (Richmond, VA)
- ** PBM Compliance Manager ( Claims Audit)** **Location:** This role requires associates to be in-office 1 - 2 days per week, fostering collaboration and ... for employment, unless an accommodation is granted as required by law. The ** PBM Compliance Manager ( Claims Audit)** is responsible for coordinating… more
- AscellaHealth (Berwyn, PA)
- …global specialty pharmacy and healthcare services organization, is seeking a Relationship Account Manager for our Berwyn, PA location. The person in this role will ... new relationships and managing existing accounts within a pharmacy benefit management ( PBM ) or health plan environment. This position is crucial to delivering value… more
- CVS Health (Buffalo Grove, IL)
- …each and every day. CVS Health has an exciting opportunity to join our PBM Customer Reporting group as a Data Engineer within our Reporting Solutions team. CVS ... with a collaborative, close-knit reporting team on pharmacy and member specific claims data including, but not limited to, financial and operational information… more
- AbbVie (Mettawa, IL)
- …or healthcare industry. + Experience with IQVIA data sources (eg HCOS data), Rx claims data, PBM rebate data. + Knowledge of 340B flows preferred. + ... maintains reporting to track performance, dashboard metrics, 340B entity eligibility compliance ), (3) manages 340B duplicate discount scrubbing (4) manages Covered… more
- CVS Health (Richardson, TX)
- …heart, each and every day. **Position Summary:** As part of the dynamic Claims Adjudication Development Engineering team, you will be expected to be proficient in ... day and is business critical. The IT Development Senior Manager position exists to successfully execute projects / initiatives...time sheets for CVS and vendor resource to ensure compliance . + You will actively participate in recruitment and… more
- Elevance Health (Atlanta, GA)
- …Management** is responsible for managing contracts and relationships with PBM vendor. Developing relationships with external vendors and internal stakeholders. ... large commercial client relationships, ensuring service excellence and contract compliance . + Act as an executive-level liaison for key...a BA/BS and a minimum of 5 years of Pharmacy/ PBM experience; or any combination of education and experience… more
- Prime Therapeutics (Baton Rouge, LA)
- …to elicit, define, and document the requirements for changes to Prime's claims systems. **Responsibilities** + Ensure understanding of business requirements and IT ... and serve as subject matter expert and mentor for other members of Claims IT team, including cross-training assigned BSAs on system requirements phase of assigned… more
- Elevance Health (Atlanta, GA)
- …duties may include, but are not limited to:** + Researches and interprets claims issues while ensuring good, accurate and timely customer service for our pharmacy ... delivery of standard and custom reports for internal and external clients, such as claims , drug utilization and impact reports to our clients in compliance with… more