- CenterWell (Springfield, IL)
- …+ Support new business implementations with a goal of ensuring all pharmacy claims are processing appropriately + Drive project development and support project ... used for prioritization purposes + Analyze data related to pharmacy trends and collaborating with internal partners and the...**Required Qualifications** + 3 - 5 years' experience with PBM operations + 3 - 5 years managing large… more
- CVS Health (Springfield, IL)
- …our rates with pharmacy provides should be set. Deep knowledge of PBM pricing and operations is necessary as well as understanding of financial statements both ... the ability to organize data around network differentiation and pharmacy status are key assets a candidate will need...and/or financial experience **Preferred Qualifications** + 2+ years of PBM experience + Ability to use SAS and Tableau… more
- ChenMed (Berwyn, IL)
- …and clinic staff on the importance of medication adherence + Represent the pharmacy department on relevant committees, payor calls, + quality teams, and market ... programs + Familiarity with appropriate local, state, and federal pharmacy -related regulations + Ability to work effectively, both independently...+ Experience in a managed care setting (HMO, MSO, PBM ) is a plus + Certified to provide immunization… more
- Prime Therapeutics (Springfield, IL)
- …and resolve regulatory inquiries/complaints related to claims, contracting and pharmacy reimbursement. Works directly with business partners across the enterprise. ... experience in legal or compliance related roles for a healthcare or PBM organization, or other highly regulated industry, including experience with Medicare,… more
- CVS Health (Springfield, IL)
- …and provides clinical oversight and mentorship for CVS Health clinical programs, PBM Clinical Quality activities, consultative support to the P&T process, formulary ... of clinical leadership to various internal departments (eg, specialty pharmacy services, clinical product development, Enterprise Analytics, Compliance, Legal,… more
- Rush University Medical Center (Chicago, IL)
- …in infusion services or other healthcare profession. *1 year experience with PBM & Major medical prior authorizations *Demonstrates basic knowledge of all technical ... **Preferred Job Qualifications:** *Associate's degree from an accredited college/university *Healthcare/ pharmacy experience desired. *CPR+ experience **Competencies:** *Computer skills (eg… more
- Prime Therapeutics (Springfield, IL)
- …visa or residency sponsorship **Additional Qualifications** + Advanced knowledge of PBM regulatory frameworks and healthcare law, with demonstrated ability to ... Statute, and False Claims Act, with a focus on PBM and managed care operations + Experience engaging with...Experience engaging with regulatory bodies (eg, CMS, OIG, state pharmacy boards) and contributing to internal or external policy… more
- Prime Therapeutics (Springfield, IL)
- …upon business needs + Other duties as assigned. **Minimum Qualifications** + Doctor of Pharmacy (PharmD) or Bachelor of Science Pharmacy Degree + 1 years of ... license in good standing with the State Board of Pharmacy in the State where the position is located....**Preferred Qualifications** + Managed care experience (Health Plan or PBM ) + Oncology experience + Board or Specialty certification… more
- Prime Therapeutics (Springfield, IL)
- …+ Coordinate formulary management for the client including, client specific Pharmacy &Therapeutics (P&T) or business committee decision making and implementation, ... Prime's operational teams to coordinate and lead client specific custom clinical pharmacy programs + Other duties as assigned **Minimum Qualifications** + PharmD or… more
- AbbVie (North Chicago, IL)
- …including but not limited to, managed care organizations (MCOs), specialty pharmacy providers (SPPs), pharmacy benefit managers (PBMs), integrated delivery ... including but not limited to, managed care organizations (MCOs), specialty pharmacy providers (SPPs), pharmacy benefit managers (PBMs), integrated delivery… more