- CVS Health (Cumberland, RI)
- …Excel skills, including financial modeling and data analysis + Experience in Pharmacy Benefit Management (PBM), pharmaceutical, or healthcare industries ... weight management programs, confidential counseling and financial coaching. + ** Benefit solutions that address the different needs and preferences of our… more
- Idaho Division of Human Resources (Boise, ID)
- …steps to identify, diagnose and resolve areas of concern related to pharmacy benefits and pharmacy benefit managers. + Perform specialized analysis of ... Pharmacy Benefits Market Examiner Posting Begin...Department of Insurance (https://doi.idaho.gov/) (DOI) is searching for a Pharmacy Benefit Market Examiner. This position is… more
- The Cigna Group (Morris Plains, NJ)
- …High school diploma or equivalent required. + 5+ years of experience in pharmacy benefit management , healthcare technology, or standards implementation. + ... Health Services** Evernorth Health Services, a division of The Cigna Group, creates pharmacy , care and benefit solutions to improve health and increase vitality.… more
- Cardinal Health (Baton Rouge, LA)
- …successful implementation. . Build strong partnerships across Patient Access, Case Management , Specialty Hubs, Pharmacy Operations, IT, and executive leadership. ... streamline patient onboarding, qualification and adherence. Our non-commercial specialty pharmacy is centralized at our custom-designed facility outside of Dallas,… more
- RxBenefits (Providence, RI)
- …+ Monitoring, researching and analyzing federal and state laws related to the healthcare/ pharmacy benefit management industry + Assist in the preparation ... advise on state and federal law specific to the healthcare/ pharmacy industry. This individual is a forward-thinking professional who..._RxBenefits is also committed to providing best in class benefits to our teammates. We offer a robust total… more
- Northwell Health (New Hyde Park, NY)
- …management (UM) criteria, and evidence-based drug therapy guidelines, and overseeing pharmacy benefit claims adjudication to match formulary intent. This role ... with a significant portion (4+ years) directly in a managed care organization, Pharmacy benefit manager, or health plans + Experience in formulary … more
- Molina Healthcare (UT)
- …provider contracting experience. * Experience with NCQA, HEDIS, Medicaid, Medicare and Pharmacy benefit management , Group/IPA practice, capitation, HMO ... Summary** Molina's Behavioral Health function provides leadership and guidance for utilization management and case management programs for mental health and… more
- Insight Global (San Diego, CA)
- …communication, and collaboration skills * Experience in healthcare, pharmacy , or pharmacy benefit management (PBM) environments * Familiarity with data ... engineering and MLOps practices (ETL pipelines, feature stores, model deployment) * Exposure to LLM-based applications, prompt engineering, and Retrieval-Augmented Generation (RAG) systems * Knowledge of visualization and reporting tools such as Superset or… more
- US Tech Solutions (May, OK)
- …Authorization(required). + MUST HAVE experience with Medicare Part D + Must Have Pharmacy Benefit Management (PBM) experience. **Education:** + Pharm D. ... and procedure. **Experience:** + Prior authorization experience required. + Previous pharmacy experience in retail or hospital preferred. + Appropriate state license… more
- Insight Global (Downers Grove, IL)
- …Description Our client is the leading health solutions company with retail locations, pharmacy benefit management , and digital health hubs. These resource ... * Knowledgeable about web security basics. * Microsoft certifications are a plus. *Experience developing healthcare, insurance, pharmacy , or claims web applications more