- Actalent (San Antonio, TX)
- …determination requests submitted by providers and assess the need for pharmacist review. + Obtain verbal authorizations and request detailed clinical information ... criteria. + Enter and document coverage determination request decisions into the PBM system and notify providers and/or members. + Respond to client inquiries… more
- Actalent (Austin, TX)
- …and making initial determination decisions-approving or denying them before forwarding to a pharmacist for final review. You'll work with a variety of health plans ... coverage determination requests submitted by healthcare providers. + Assess whether pharmacist review is necessary for specific requests. + Obtain verbal… more
- Baylor Scott & White Health (Temple, TX)
- …This includes selecting and managing the outsourced Pharmacy Benefit Manager ( PBM ). They also handle the purchase, storage, compounding, packaging, and dispensing ... and total net earnings. + Oversees the Pharmacy Benefit Manager ( PBM ) relationship, ensuring market competitiveness, long-term value for customers and clinical… more
- Actalent (Dallas, TX)
- …Track coverage determination requests submitted by providers and assess if a pharmacist review is necessary. + Obtain verbal authorizations and request detailed ... criteria. + Enter and document coverage determination request decisions into the PBM system and notify providers and/or members. + Respond to client inquiries… more
- Actalent (Dallas, TX)
- …triage coverage determination requests submitted from providers and determine if a pharmacist review is required + Obtain verbal authorizations and request detailed ... defined criteria + Enter and document coverage determination request decision into the PBM system and notify providers and/or members + Respond to client inquiries… more
- Prime Therapeutics (Austin, TX)
- …Experience within the PBM industry, Medicaid, Medicare, and health plans + Pharmacist / Pharm D + Experience with contract language and risk mitigation concepts ... years of related work experience in healthcare, pharmacy benefit management ( PBM ), pharmaceutical sales, analytical contracting or business development; also to… more
- Prime Therapeutics (Austin, TX)
- …+ Doctor of Pharmacy (PharmD) or Bachelor of Science Pharmacy degree + Current pharmacist license in good standing with the State Board of Pharmacy in the State ... + 10 years of work experience within medical and pharmacy drug management within a PBM or managed care organization + Must be eligible to work in the United States… more
- Prime Therapeutics (Austin, TX)
- …+ Doctor of Pharmacy (PharmD) or Bachelor of Science Pharmacy degree + Current pharmacist license in good standing with the State Board of Pharmacy in the State ... of work experience within medical and pharmacy drug management within a PBM or managed care organization, or oncology management experience if supporting oncology… more
- WTW (Houston, TX)
- …within the practice as well as engage in cross-functional activities. A pharmacist is strongly preferred but not required. **The Role** + Provide value-added ... design and cost savings strategies + Pharmacy Benefits Manager ( PBM ) vendor procurement and negotiation + Audits of ...PBM ) vendor procurement and negotiation + Audits of PBM performance (financial and operational) + Strategy for Specialty… more
- Intermountain Health (Austin, TX)
- **Job Description:** The Pharmacy Government Stars Pharmacist Coordinator plays a pivotal role in improving the quality performance of government-sponsored ... work Monday - Friday from 8-5. No holidays. Must have an active Pharmacist license.** **Essential Functions** + Meets or exceeds performance standards for calls,… more