- CVS Health (Tallahassee, FL)
- …of AS400. Experience with either of these systems or prior exposure to the PBM or Medicaid industry would be advantageous. The ability to think critically and ... multitask is very valuable in this role. Additionally, you will be an integral part of recurring client meetings. You must be comfortable and adept with clearly communicating technical information (verbal and written) to non-technical people and leading… more
- Highmark Health (Tallahassee, FL)
- …**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 work under… more
- CVS Health (Tallahassee, FL)
- …database administration **Preferred Qualifications** + Healthcare Insurance and PBM knowledge including Prior Authorizations, Claims, Rebates, Network contracting, ... Sales, Call Center Ops and Pharmacy Ops + Business process design and development experience using SSMS (Sql Server Management Studio) Agent + SQL job monitoring, troubleshooting and issue resolution with the potential of off hour support + SQL programming, MS… more
- Humana (Tallahassee, FL)
- …line of business. + Utilizes broad understanding of pharmacy, managed care, PBM , market and regulatory insights to support the implementation of formulary and ... medical strategies to mitigate Humana's costs and trend while improving our member's health outcomes and costs. + Performs formulary and medical drug list analysis and reporting that assist in the decision making of Medicaid drug strategies. + Works across… more
- Convey Health Solutions (Fort Lauderdale, FL)
- …CMS Daily and Monthly Reconciliation queues + Daily and Monthly Pharmacy Benefit Manager ( PBM ) + Monthly MMR, PWR, LIS History and LEP Reconciliation + Daily OHI/COB ... Rejections + Monthly review and preparation of the CMS Enrollment Data Validation file and submissions All Functions + Working understanding of Centers for Medicare & Medicaid Services (CMS) guidance + Conform with and abide by all regulations, policies, work… more
- Prime Therapeutics (Tallahassee, FL)
- …skills required. **Preferred Qualifications** + Managed care experience (Health Plan or PBM ) + Oncology experience + Board or Specialty certification + Decision ... support tool experience (eg, order sets) Every employee must understand, comply with and attest to the security responsibilities and security controls unique to their job, and comply with all applicable legal, regulatory, and contractual requirements and… more
- The Cigna Group (Tampa, FL)
- …new business. The Account Executive educates prospective customers on Workers Compensation PBM , the market environment, and the interactions with claims payers. The ... Account Executive works closely with Marketing, Clinical Team, Product, and Operations staff to ensure our tradition of excellent customer service. Additionally, they will respond to RFP's, deliver a compelling price and service proposal, manage capabilities… more
- ChenMed (Miami, FL)
- …and/or supporting Pharmacy Technicians + Experience in a managed care setting (HMO, MSO, PBM ) is a plus + Certified to provide immunization is a plus + Completion ... of Medication Therapy Management certificate program or Ambulatory Care Certificate a plus We're ChenMed and we're transforming healthcare for seniors and changing America's healthcare for the better. Family-owned and physician-led, our unique approach allows… more
- Actalent (Miami, FL)
- …Pharmacy Technician license (required) + Previous experience in a managed care, PBM , or clinical pharmacy setting preferred + Strong communication skills and ... attention to detail + Comfortable working independently in a remote environment + Reliable internet connection and secure workspace Schedule & Pay + Full-time, Monday-Friday + $19/hour + Remote (license required; must reside in the US) Why This Role? This is a… more
- Elevance Health (Tampa, FL)
- …+ Project Management Professional (PMP) certification preferred. + Prior experience with PBM or Health plan strongly preferred. + Experience with Smartsheet, MS ... Project, MS Powerpoint, and JIRA Strongly preferred. Please be advised that Elevance Health only accepts resumes for compensation from agencies that have a signed agreement with Elevance Health. Any unsolicited resumes, including those submitted to hiring… more