- AscellaHealth (Berwyn, PA)
- …specialty pharmacy and healthcare services organization, is seeking a Senior 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
- Highmark Health (Harrisburg, PA)
- …the pharmacy as well as the medical benefits. This job will have a strong compliance focus to ensure adherence to CMS turnaround times for ACA and MA members and ... pharmacy edits. + Ensures adherence to all regulatory and compliance guidelines (CMS, NCQA, DOH, etc.) as it pertains...years in managed care pharmacy and/or pharmacy benefit management ( PBM ) + 1 year in a leadership role with… more
- Prime Therapeutics (Harrisburg, PA)
- …every decision we make. **Job Posting Title** Sr. Functional Bus Consultant ( Compliance ) - Remote **Job Description** The Senior Functional Business Consultant The ... Functional Business Consultant serves as a project manager **,** business system or business process subject matter expert with a high level of understanding of… more
- Deloitte (Philadelphia, PA)
- …projects or key workstream lead on larger projects. + Evaluate Pharmacy Benefit Manager ( PBM ) contracts, deal terms, and financial proposals. + Be conversant ... Advise clients on industry trends, best practices, regulatory updates, and compliance deadlines. + Evaluate vendors by reviewing services, contracts, performance… more
- CenterWell (Harrisburg, PA)
- …and operations for multiple Medicaid markets. This role is responsible to ensure compliance with client contracts, as well as to identify opportunities and implement ... **Required Qualifications** + 3 - 5 years' experience with PBM operations + 3 - 5 years managing large...of home health services, and fourth largest pharmacy benefit manager , CenterWell is focused on whole-person health by addressing… more
- Highmark Health (Harrisburg, PA)
- …MS Access **Preferred** + Prior pharmacy experience with a pharmacy benefit manager ( PBM ), consultant, pharmacy provider, or another organization specializing in ... pharmacy **Skills** + Strong written and oral communication skills + Strong relationship building skills + Client focused with strong business acumen + Self-starter with the ability to work under pressure independently and as part of a team + Ability to think… more
- Prime Therapeutics (Harrisburg, PA)
- …Account Consultant Sr - Remote **Job Description** The Senior Employer Account Manager is responsible for providing complex level support for the Employer Account ... at all levels within an organization + Ability to balance and prioritize compliance , business and other competing goals and risks, while still driving programs and… more
- Prime Therapeutics (Harrisburg, PA)
- …**Preferred Qualifications** + Experience working in environment with regulatory compliance requirements (HIPAA, PCI, etc.) + Previous experience in ... PBM / health care industry + Understanding of security...to adjust focus **Reporting Structure** + Reports to a Manager in the IT department Potential pay for this… more
- UPMC (Erie, PA)
- …Federal and State laws (eg, HIPAA), regulations (eg, OSHA), and Pharmacy Benefit Manager ( PBM ) contracting requirements (eg, FWA and CMS). Completion of high ... medication filling, and medication distribution. All services are provided in strict compliance with Department of Health, The Joint Commission, and State Board of… more