- Premera Blue Cross (Mountlake Terrace, WA)
- …a strategic Health Plan Pharmacy leader that will oversee pharmacy clinical operations, PBM relationship, formulary, utilization management, and other ... of Pharmacy & Clinical Consulting to drive business outcomes. The **Director, Pharmacy Operations & PBM Management** will provide direction and oversight in… more
- CareFirst (Baltimore, MD)
- …and subsystems supporting end-to-end technical and operational accountability for all Pharmacy Benefit Management ( PBM ) related programs, technical design, ... (all benefits/incentives are subject to eligibility requirements). **Department** 2024-2026 PBM / Pharmacy RFP **Equal Employment Opportunity** CareFirst BlueCross… more
- CVS Health (Scottsdale, AZ)
- …to join our PBM Finance Enablement team as a Manager, Compliance Pharmacy Payments within the PBM Reporting team. CVS Health strives to continuously ... to cloud platforms + Experience in healthcare industry, including health insurance, PBM or pharmacy services + Experience with process improvement methodologies… more
- CVS Health (Irving, TX)
- …pharmacy claims data * Experience in healthcare industry, including health insurance, PBM or pharmacy services **Education** * Bachelor's degree in computer ... CVS Health has an exciting opportunity to join our PBM Reporting group as a Data Engineer within our...You will work with a collaborative, close-knit team on pharmacy and member specific claims data including, but not… more
- US Tech Solutions (May, OK)
- …based on prior authorization as per policy and procedure. **Experience:** + Previous pharmacy experience in PBM ( Pharmacy Benefits Management) required. + ... that experience are preferred. **Skills:** + Prior authorization + PBM **Education:** + Bachelor's degree in pharmacy or Pharm D. Must have an active license in… more
- The Cigna Group (Bloomfield, CT)
- **Job Description Summary:** The Managing Director of the Pharmacy Benefit Management ( PBM ) Customer Service Operations will be responsible for leading and ... + Strong problem-solving and decision-making abilities. + Desired strong understanding of PBM operations, pharmacy benefits, and healthcare regulations If you… more
- CVS Health (Albany, NY)
- …each and every day. Provides strategic direction and leadership for the specialty pharmacy benefit management ( PBM ) business unit, setting goals and objectives ... the organization's mission and vision. Oversees the overall specialty pharmacy strategy for Caremark's largest PBM client....overall specialty pharmacy strategy for Caremark's largest PBM client. The position requires the ability to work… more
- System One (Baltimore, MD)
- …with a leading health insurance company. This role requires deep expertise in pharmacy supply chain financial management, PBM transitions, and pharmacy ... operations. The Program Manager will lead a major pharmacy supply chain implementation and PBM transition, overseeing execution activities, stakeholder… more
- Highmark Health (Providence, RI)
- …to support inputs into financial plan, trends, forecast and accrual assumptions. + Pharmacy Benefit Manager ( PBM ), pharmacy Group Purchasing Organization ... in Data Analytics or Financial Reporting + 5 years of experience in PBM or Pharmacy finance **Preferred** + None **SKILLS** + Strong Financial Acumen + Strategy… more
- CVS Health (Scottsdale, AZ)
- …it all with heart, each and every day. **Job Description** The VP, Rebate and Pharmacy Benefit Manager ( PBM ) Operations will lead a team of approximately 400 ... 10+ years of experience in healthcare industry, including health insurance, PBM or pharmacy services + Subject matter expertise in Finance, Accounting and… more
- Highmark Health (Wexford, PA)
- …for all preauthorization entries into applicable databases (ie internal medical claims systems, PBM pharmacy systems) to ensure swift and appropriate payment of ... Coordinates and administers the effective and efficient processing of the pharmacy benefits prior authorization process, ensuring that pharmacy benefits… more
- CareFirst (Baltimore, MD)
- …(all benefits/incentives are subject to eligibility requirements). **Department** 2024-2026 PBM / Pharmacy RFP Pro **Equal Employment Opportunity** CareFirst ... strategic technology direction and creating solution architecture for the Pharmacy business and across large complex initiatives/projects, including Pharmacy… more
- Fairview Health Services (Minneapolis, MN)
- …15+ years relevant work experience in strategy development and account management, in the PBM , specialty pharmacy , and/or managed care industry. + 15+ years of ... relevant work experience performing analytics in the PBM , specialty pharmacy , and/or managed care industry. + 10+ years of leadership/people management… more
- CareFirst (Baltimore, MD)
- …(all benefits/incentives are subject to eligibility requirements). **Department** PBM / Pharmacy RFP **Equal Employment Opportunity** CareFirst BlueCross ... **Resp & Qualifications** **PURPOSE:** Serves as an authority over Pharmacy Product Owners and product teams to ensure clarity in strategic direction. Brings an… more
- CareFirst (Baltimore, MD)
- …(all benefits/incentives are subject to eligibility requirements). **Department** PBM / Pharmacy RFP **Equal Employment Opportunity** CareFirst BlueCross ... Manages and oversees the teams responsible for design and development of Pharmacy solutions, and their operations and maintenance. Directs the work of engineers… more
- CDPHP (Albany, NY)
- …experience without a CPT or completion of CPT accredited program. + Experience with pharmacy claims processing, PBM systems, pharmacy billing and payment ... Under the direct supervision of a licensed pharmacist, the Managed Care Pharmacy Technician ( Pharmacy Tech) is responsible for administering CDPHP member… more
- AbbVie (North Chicago, IL)
- …Practice Act. + A minimum of 3-5 years' experience within a healthcare provider, PBM , Specialty Pharmacy or Retail/Mail Order Pharmacy setting, familiarity ... Job Description Responsible for providing leadership, support, and supervision to the Pharmacy Technician and the Fulfillment teams to ensure all day to day… more
- CVS Health (Scottsdale, AZ)
- …more years Project Management experience **Preferred Qualifications** + Thorough knowledge of PBM and pharmacy industry + Proficiency in software applications ... each and every day. **Position Summary** As the Medicare Pharmacy Audit Programs Project Manager you will be responsible...Manager you will be responsible for administering Medicare Part-D Pharmacy Audit Programs. In this role, you will be… more
- St. Luke's Health System (Boise, ID)
- … Pharmacy Benefits Specialist assists our members in identifying and navigating pharmacy benefits management ( PBM ) and third-party issues such as prior ... insurance overrides and processes prior authorizations. If you have PBM , retail and/or strong pharmacy billing experience and have a valid Idaho Pharmacy… more
- Independent Health (Buffalo, NY)
- …+ PharmD required, MBA degree preferred. + Two (2) years of healthcare pharmacy or PBM industry experience required. + Strong problem solving, analytical, ... Trade Relations Executive is responsible for monitoring and researching the specialty pharmacy industry for new best practices and unique programs or service… more