- CVS Health (New York, NY)
- …heart, each and every day. **Position Summary** **Calling all experienced Healthcare, PBM or Pharmacy Consultants looking for a rewarding career, while also enjoying ... work, life, balance. Come join our team as we lead the industry in Healthcare!** The Enterprise Strategy team is responsible for helping steward the development of the company's long-term strategy and associated priorities, connecting each business unit to… more
- Highmark Health (Pittsburgh, PA)
- …preauthorization entries into applicable databases (ie, internal medical claims systems, PBM pharmacy systems) to ensure swift and appropriate payment of services ... deemed medically necessary. Conducts insurance evaluations to determine patient eligibility and coverage for services. Performs medication reconciliation tasks to ensure accurate medication lists and prevent potential drug interactions. Maintains regulatory… more
- CVS Health (Irving, TX)
- …and/or large-scale, highly visible arrangements simultaneously - Experience within the PBM , Retail and/or Healthcare Industries is preferred. - Experience in ... negotiating non-merchandise/indirect commodity purchases of goods and/or services deals/contracts is preferred - Experience with Ariba Contract Management or a similar contracts management system tool / platform is strongly preferred. - Ability to balance… more
- Beth Israel Lahey Health (Westwood, MA)
- …certification. 2. Specialty Pharmacy experience. 3. Pharmacy data entry and PBM Billing experience. **Competencies:** 1. **Decision Making:** Ability to make ... decisions that are based on specific instructions, standard practices and established procedures which generally require little or no supervision. 2. **Problem Solving:** Ability to address problems that are routine, somewhat repetitive and generally solved by… more
- UPMC (Pittsburgh, PA)
- …with Federal and State laws (such as HIPAA), regulations (such as OSHA), and PBM contracting requirements (such as FWA and CMS). + Use computer skills to process ... and maintain all patient information and records. + Phone call triage 2. Distribution: + Participate in the distribution of medication, including medication cassettes, emergency medication carts, and the delivery of controlled substances per department policy… more
- Lowe's (Mooresville, NC)
- …Serves as the collaboration consultant for key initiatives like LowesForPros.com, PBM , new programs or field organization communities on connections **Minimum ... Qualifications** + Associate degree Business Administration, Communication, Education/Training, or related field or equivalent years of experience in lieu of education requirement, if applicable + Bachelor's degree Business Administration, Communication,… more
- Molina Healthcare (Tampa, FL)
- …with monitoring and oversight of Molina's contracted Pharmacy Benefit Manager ( PBM ) for pharmacy contractually delegated functions. * Responsible for key performance ... indicators (KPI) reporting to department leadership on a monthly basis. * Participates, researches, and validates materials for both internal and external program audits. * Acts as liaison to internal and external customers to ensure prompt resolution of… more
- Amneal Pharmaceuticals (Bridgewater, NJ)
- …access/customer-facing contracts including product purchase, supply, distribution, PBM , GPO, wholesaler/distribution, rebate/discount, and specialty pharmacy ... agreements. Provide legal guidance on contracting and strategy for established and newly launched products. more
- St. Luke's Health System (Boise, ID)
- …our members in identifying and navigating complex pharmacy benefits management ( PBM ) and third-party issues such as prior authorization, step therapy, reviewing ... denied claims, and processing overrides. Works with an interdisciplinary team of pharmacy staff, patient financial advocates, the pharmacy authorization team, clinic staff, and providers. Issues insurance overrides and processes prior authorizations. **What to… more
- Elevance Health (Columbus, OH)
- …+ Travels to worksite and other locations as necessary. + PBM experience preferred. + Client-facing experience preferred. + Account management experience ... within healthcare preferred. For candidates working in person or virtually in the below location(s), the salary* range for this specific position is $66,640 to $99,960 Locations: Columbus, OH In addition to your salary, Elevance Health offers benefits such as,… more
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