- CVS Health (Chicago, IL)
- …has an exciting opportunity to join our PBM Finance Enablement team as a Manager , Compliance Pharmacy Payments within the PBM Reporting team. CVS Health ... exciting opportunity to join our PBM Finance Enablement team as a Manager , Compliance Pharmacy Payments within the PBM Reporting team. CVS Health strives… more
- Elevance Health (Houston, TX)
- …and improved overall health outcomes by putting the patient first._ **Title** : PBM Pricing Strategy Analyst Manager **Hybrid:** This role requires associates to ... may be considered. **Build the Possibilities. Make an Extraordinary Impact.** The ** PBM Pricing Strategy Analyst Manager ** is responsible for Pharmacy Services… more
- System One (Baltimore, MD)
- …company. This role requires deep expertise in pharmacy supply chain financial management, PBM transitions, and pharmacy operations. The Program Manager will lead ... Job Title: Pharmacy Benefits Manager Consultant Client: Health Insurance Organization Location: Remote...a major pharmacy supply chain implementation and PBM transition, overseeing execution activities, stakeholder alignment, contract and… more
- Prime Therapeutics (Baton Rouge, LA)
- …Posting Title** Manager , Compliance - Remote **Job Description** The Compliance Manager works closely with designated business areas, Legal, and other ... changing laws and regulations, accreditation standards, and client contractual compliance obligations, interpret the impact, and manage solutions for designated… more
- The Cigna Group (Denver, CO)
- **SOC 1 Compliance and Delivery Manager ** This is a senior, individual contributor role **Job Description:** This is a global role focused on leading SOC1 ... for System and Organization Controls (SOC1) Reports. The SOC1 Compliance and Delivery Manager will collaborate with...SOC2 and SOX + Experience in auditing pharmacy benefit manager ( PBM ) and corporate functions preferred +… more
- CVS Health (Des Moines, IA)
- …do it all with heart, each and every day. **Position Summary** The ** PBM Data Analyst** performs prescription claim and accumulator audits, verifies policy coverage, ... assesses claim validity, and communicates with PBM ( _Pharmacy Benefit Manager_ ) vendors & client...overages. + Maintains electronic records, updates information, and ensures compliance with relevant policies and regulations. + Assists with… more
- KPH Healthcare Services, Inc. (East Syracuse, NY)
- …position or similar + Preferred: minimum of 1 year in a pharmacy benefit manager ( PBM ) setting with working knowledge of operations. **Special Conditions of ... **Overview** **Scope of Responsibilities:** Assist with regulatory and compliance matters within ProAct. **Job Summary:** Responsible for administrative tasks to… more
- VNS Health (Manhattan, NY)
- …Drug Event Reports and sees that staff, other MA/PD plans, and Pharmacy Benefit Manager ( PBM ) work to resolve edits and errors. Identifies, tracks and trends ... of data transfers. Monitors enrollment processing activities to ensure compliance to Center for Medicare and Medicaid Services (CMS)...issues and alerts PBM as necessary, assist with finding resolutions as deemed… more
- Highmark Health (Trenton, NJ)
- …or CERTIFICATIONS** **Required** + 5 years in a Health Plan or Pharmacy Benefit Manager ( PBM ) + 3 years of leading healthcare program or product development ... A proven ability to navigate complex regulatory landscapes (including CMS compliance ) and a comfort level tackling ambiguous, high-stakes challenges is crucial… more
- Prime Therapeutics (Carson City, NV)
- … compliance or operations related roles in the healthcare or Pharmacy Benefit Manager ( PBM ) industry + 1 year of leadership/people management experience + ... It fuels our passion and drives every decision we make. **Job Posting Title** Manager , Client Audit Services - Remote **Job Description** The Manager Client… more