- KPH Healthcare Services, Inc. (East Syracuse, NY)
- …actionable recommendations to leadership. + Serve as the primary contact for PBM contract negotiations. + Prepare financial models and business cases to support ... and other payers. + Maintain and nurture strong working relationships with PBM representatives and payer partners to ensure favorable contract outcomes and resolve… more
- Deloitte (Jericho, NY)
- …projects or key workstream lead on larger projects. + Evaluate Pharmacy Benefit Manager ( PBM ) contracts, deal terms, and financial proposals. + Be conversant ... Pharmacy Benefit Manager /Health & Group Benefits Senior Consultant Human CapitalOur...clients on industry trends, best practices, regulatory updates, and compliance deadlines. + Evaluate vendors by reviewing services, contracts,… 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
- Elevance Health (New York, NY)
- …patient care outcomes, enhancing service delivery, and ensuring regulatory compliance . Functions that this role oversees include case management, prescription ... strategies to ensure affordability, generic utilization, and medication adherence in compliance with contract language and state/federal regulations. + Oversee a… more
- Mount Sinai Health System (New York, NY)
- …direct supervision of the Director of Specialty Pharmacy, the Specialty Pharmacy Manager and the Specialty Pharmacy Clinical Liaison, the Specialty Pharmacy Access ... contacts may include third party payers, accrediting bodies, insurance / PBM companies, government peer review organizations, accrediting bodies,external partners,… more
- University of Rochester (Rochester, NY)
- …is responsible for the oversight, operational integrity, regulatory/legal compliance and financial performance for all Ambulatory/Outpatient pharmacy programs ... procedures across the UR Medicine outpatient pharmacy system to ensure compliance with State and Federal Regulations, accreditation standards and third-party payer… more
- New York Edge (Bronx, NY)
- …Performs audits to validate the accuracy of data maintained. * Ensures compliance with local, state and institutional regulations. * Designs, develops and implements ... and school data team to ensure data tracking and compliance * Obtain knowledge program goals and requirements for...business issues and data challenges of the industry and PBM organizations. * Assist with ongoing quality control and… more
- Highmark Health (Albany, NY)
- …MS Access **Preferred** + Prior pharmacy experience with a pharmacy benefit manager ( PBM ), consultant, pharmacy provider, or another organization specializing in ... pharmacy **LICENSES or CERTIFICATIONS** **Required** + None **Preferred** + None **SKILLS** + Strong written and oral communication skills + Strong relationship building skills + Client focused with strong business acumen + Self-starter with the ability to… more