- Sanofi Group (Morristown, NJ)
- …knowledge of the payer data ecosystem, including formulary/UM criteria databases, payer-plan- PBM hierarchies, lifecycle claims, use of APLD/rebate data in GTN ... analysis. + Knowledge of special and emerging areas like patient tokenization, specialty pharmacies / IDN specialty pharmacies / SP data integration, SDOH. + Knowledge of and/or experience in MR, forecasting, analytics, reporting, MMX, etc. **Why Choose Us?**… more
- Humana (Trenton, NJ)
- …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
- Prime Therapeutics (Trenton, NJ)
- …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
- Teva Pharmaceuticals (Parsippany, NJ)
- …GTN. This means developing and aligning stakeholders on strategies across Payer/ PBM , Wholesale/Distribution, Point of Purchase Channels (ie SP, LTC, 340B, etc.), ... copay This role is responsible for brands across the product life cycle: pre-product launch, launch, in-line, and mature. This role manages individuals supporting Value & Access Strategy across specific brands and may also be responsible for certain brands. IN… more
- Prime Therapeutics (Trenton, NJ)
- …Provide tactical legal advice and support to internal clients including PBM , pharmacy, specialty pharmacy, government programs, administrative support functions or ... other areas as assigned + Perform research, drafting and transactional work in support of legal matters; may manage litigation efforts for assigned business area + Advise internal clients regarding compliance with regulatory requirements and corporate… more
- Prime Therapeutics (Trenton, NJ)
- …degree or other advanced degree + 3 years of Pharmacy Benefit Management ( PBM ) experience 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 internal policies and procedures Every employee must be able to perform the essential functions of the job and, if… more
- Prime Therapeutics (Trenton, NJ)
- …with regulatory compliance requirements (HIPAA and/or PCI) + Previous experience in PBM / health care industry + Strong experience with software development life ... cycle and project management principles + In-depth knowledge of two or more architectural domains (application, infrastructure, integration, and/or security + Master's degree in Computer Science or related area of study, or equivalent combination of education… more
- Prime Therapeutics (Trenton, NJ)
- …analysis to include 3 years of experience in Pharmacy Benefit Management ( PBM ), claims processing, healthcare, and/or related field + Previous experience using SQL, ... SAS, Alteryx, R, Python or related technologies + Must be eligible to work in the United States without the need for work visa or residency sponsorship Must be eligible to work in the United States without the need for work visa or residency sponsorship.… more
- Prime Therapeutics (Trenton, NJ)
- …with FinOps practices and frameworks. + Familiarity with healthcare or PBM industry. + Leadership or team management experience. + **Scripting/querying** : ... SQL, Python, or Shell for cost analysis and automation + **Cloud cost management tools** : AWS Cost Explorer, GCP Cost Management, Cloud Health, Cloud ability **Physical Demands** + Constantly required to sit, use hands to handle or feel, talk and hear +… more
- The Cigna Group (Morris Plains, NJ)
- …value in pharmacy, medical and beyond to further total health for all. Express Scripts PBM is evolving. We are now part of EvernorthSM Health Services built on the ... recognition that health is the starting point for human potential and progress. Evernorth brings together health service capabilities including pharmacy solutions, benefits management, care solutions and data intelligence to deliver differentiated value. All… more