- Actalent (Houston, TX)
- …criteria. + Enter and document coverage determination request decisions into the PBM system and notify providers and/or members. + Respond to client inquiries ... regarding authorization approvals and PBM online applications. + Refer coverage determination requests for...for some supervisory roles. + Experience in call centers, PBM , hospitals, or specialty pharmacies. + Certified Pharmacy Technician… more
- Prime Therapeutics (Austin, TX)
- …competitive dynamics and emerging entrants in the Pharmacy Benefit Management ( PBM ) space, including implications of acquisitions, service expansions, and disruptive ... required + 12 years of Finance, Analytics, or Business Economics within healthcare, PBM , specialty pharmacy, or healthcare consulting + Must be eligible to work in… more
- Apex Health Solutions (Houston, TX)
- …relates to CMS and other regulatory entities. Interacts with pharmacy benefit manager ( PBM ) to support the implementation of new pharmacy products or services and ... Excellent verbal and written communication skills Working knowledge of PBM system or experience working in a health plan...retail or community pharmacy setting, health plan, HMO and/or PBM setting. OR . Prior population health experience or… more
- CVS Health (Irving, TX)
- …Team supports CVS Caremark, the nations leading pharmacy benefit manager ( PBM ). Implementations Managers play a critical role in onboarding new clients, ... lines of business and implementing plan changes. Given the complexities of todays PBM landscape, setting up a new client involves managing financial, product, and… more
- Prime Therapeutics (Austin, TX)
- …develops and applies advanced knowledge of pricing strategies in the PBM industry; provides underwriting services to determine pricing and monitors accounts ... in Finance or Accounting, including 3 years in the PBM industry + Must be eligible to work in...Qualifications** + 5 years of finance experience in the PBM industry + Progressive underwriting experience **Physical Demands** +… more
- CVS Health (Austin, TX)
- …Qualifications** * 2+ years' experience working as a pharmacist in a PBM setting. * Current experience working with commercial Prior Authorizations in Caremark ... PBM * Experience using clinical resources, eg, Micromedex, Lexicomp, Clinical Pharmacology * Ability to prioritize, quickly assess, manage multiple tasks and adapt… more
- CVS Health (Austin, TX)
- …each and every day. CVS Health has an exciting opportunity to join our PBM Customer Reporting group as a Senior Reporting Analyst within our Compliance Pharmacy ... pharmacy claims data. + Experience in healthcare industry, including health insurance, PBM or pharmacy services. **Education** + Bachelor's degree or equivalent work… more
- Actalent (Dallas, TX)
- …defined criteria + Enter and document coverage determination request decision into the PBM system and notify providers and/or members + Respond to client inquiries ... regarding authorization approvals and PBM on-line applications + Refer coverage determination requests for specialty drugs to delegated vendor or client for… more
- Humana (Austin, TX)
- …Pharmacist Lead requires a broad understanding of pharmacy, managed care, PBM , market and regulatory insights to develop, and/or implement formulary strategies ... line of business. + Utilizes broad understanding of pharmacy, managed care, PBM , market and regulatory insights to support the development of formulary strategies… more
- Prime Therapeutics (Austin, TX)
- …for maintaining and applying knowledge of pricing strategies in the PBM industry. **Responsibilities** + Oversees and coordinates workflow for the existing ... + 2 years of experience as a Senior Underwriter or Benefits Consultant + PBM experience **Physical Demands** + Constantly required to sit, use hands to handle or… more