- Actalent (North Chicago, IL)
- …+ Experience in a Specialty Pharmacy or Retail/Mail Order Pharmacy, PBM , or healthcare provider setting. + Familiarity with medical record handling/documentation ... and prescription data entry. + Strong customer service and inter-professional communication skills. + Core insurance knowledge including medical and pharmacy benefits. + Experience with online verification systems is preferred. + Certified Pharmacy Technician… more
- Actalent (Libertyville, IL)
- …+ Experience in a Specialty Pharmacy or Retail/Mail Order Pharmacy, PBM , or healthcare provider setting. + Familiarity with medical record handling/documentation ... and prescription data entry. + Strong customer service and inter-professional communication skills. + Core insurance knowledge including medical and pharmacy benefits. + Experience with online verification systems is preferred. + Certified Pharmacy Technician… more
- CenterWell (Santa Fe, NM)
- …on continuously improving consumer experiences **Preferred Qualifications** + managing complex PBM projects **Additional Information** As part of our hiring process ... for this opportunity, we will be using an interviewing technology called HireVue to enhance our hiring and decision-making ability. HireVue allows us to quickly connect and gain valuable information from you pertaining to your relevant skills and experience at… more
- Cognizant (Teaneck, NJ)
- …+ Masters or MBA degree + Experience in strategy divisions within Provider, PBM , Payer, and Life Sciences + Experience collaborating with, and reporting to, CxO ... executives + Experience in Big 4 management firms + 5+ years as a Digital technology (business or technical consultative) team lead + Experience coordinating workstreams in multi-team projects using an onsite / offshore model We're excited to meet people who… more
- The Cigna Group (Bloomfield, CT)
- …years of experience managing large privacy incidents.** + Healthcare and/or PBM privacy and compliance experience required + Demonstrated experience leading teams ... and driving incident management processes. + Strong analytical, communication, and interpersonal skills; proven ability to work cross-functionally and influence stakeholders. + Knowledge of State and Federal breach notification laws, including HIPAA. +… more
- Health Care Service Corporation (Richardson, TX)
- …JOB REQUIREMENTS** **:** + Knowledge of Medicaid and/or Medicare health plan and PBM operations. + Additional degrees or credentials outside the pharmacy area (such ... as an MBA). + 3 years of supervisory or management experience in a Pharmacy environment including managing a budget. **Are you being referred to one of our roles? If so, ask your connection at HCSC about our Employee Referral process!** **Pay Transparency… more
- Robert Half Technology (Princeton, NJ)
- …Benchmark pricing strategies across therapeutic areas and geographies; track payer/ PBM behavior, formulary trends, and contract performance. Oversee advanced ... analytics efforts, including price elasticity analysis, scenario modeling, and value-based pricing strategy development. Use claims data and forecasting tools to inform data-backed reimbursement strategies. Collaborate cross-functionally with Market Access,… more
- Sumitomo Pharma (Lansing, MI)
- …and developing new approaches, processes and methodologies + Experience evaluating PBM /payer contracts to ensure they support Market Access objectives + ... Highly-skilled in influencing and effectively partnering with cross-functional teams + Excellent interpersonal, oral and written communication skills, project management, and confident executive presence + High level of proficiency with Microsoft Excel and… more
- Norstella (Lincoln, NE)
- …understanding of current and future payer trends; intimate knowledge of Payer, PBM , and IDN organization structures and offerings; understands nuances of channels, ... benefit designs, site of care; understands and appreciates contracting strategies pharmaceutical companies deploy to obtain favorable access). + Understanding of common brand strategies to optimize patient access to therapies. + Able to lead multiple strategic… more
- UPMC (Pittsburgh, PA)
- …Coverage Determination (LCD). + Evaluate referrals from Pharmacy Benefit Manager ( PBM ) by analyzing medical and pharmacy claims and associated clinical documentation ... in HealthPlaNET, Mars, Epic and/or Cerner. + Complete audits by utilizing standard coding guidelines and principles and coding clinics to verify that the appropriate CPT codes/DRGs were assigned and supported in the medical record documentation. + Attend in… more