- 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 ... CVS Health has an exciting opportunity to join our PBM Customer Reporting group as a Manager ,...reporting efficiency, and look for ways to further automate Compliance Pharmacy Payments reporting activities. You will mentor teammates… more
- AscellaHealth (Berwyn, PA)
- …specialty pharmacy and healthcare services organization, is seeking a Senior Relationship Account Manager for our Berwyn, PA location. The person in this role will ... new relationships and managing existing accounts within a pharmacy benefit management ( PBM ) or health plan environment. This position is crucial to delivering value… more
- The Cigna Group (Philadelphia, PA)
- **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
- Blue Cross Blue Shield of Massachusetts (Hingham, MA)
- …healthcare? Bring your true colors to blue. The Pharmacy Operations Clinical Pharmacist Manager manages and directs clinical staff in the day to day clinical ... Day to Day: + Partner with Clinical Pharmacy and PBM Clinical teams to assist with strategic planning, development,...in conjunction with the Operations Managers to ensure regulatory compliance with CMS Chapter 18, and NCQA guidelines +… more
- Prime Therapeutics (Harrisburg, PA)
- …or GED is required + 5 years of progressive work experience in legal or compliance related roles for a healthcare or PBM organization, or other highly regulated ... tracking, renewing and submitting applications for licensure **Preferred Qualifications** + PBM /health care experience + Certified Compliance and Ethics… more
- ChenMed (Miami, FL)
- …we need great people to join our team. The Lead, Pharmacy Credentialing Benefit Manager (PCBM) is responsible for leading the effort to secure licenses and permits ... of new dispensaries. The incumbent in this role works directly with PBM contract counterparts to successfully manage the credentialing and recredentialing of new… 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
- CVS Health (Hartford, CT)
- …it all with heart, each and every day. Position Summary: The Senior Manager , Legal Contracts participates in the development and fulfillment of market conduct ... examination or state and federal investigation requests in support of Caremark's PBM business. Evaluates market conduct matters and other regulatory requests and… more
- Highmark Health (Harrisburg, PA)
- …the pharmacy as well as the medical benefits. This job will have a strong compliance focus to ensure adherence to CMS turnaround times for ACA and MA members and ... pharmacy edits. + Ensures adherence to all regulatory and compliance guidelines (CMS, NCQA, DOH, etc.) as it pertains...years in managed care pharmacy and/or pharmacy benefit management ( PBM ) + 1 year in a leadership role with… more
- Amazon (Boston, MA)
- …representing Amazon pharmacy with key relationships for Pharmacy Benefit Managers ( PBM 's), Manage Care Organizations (MCO's) Health Insurers (Health Plans, and ... Basic Qualifications - 10+ yrs overall experience preferably in PBM , health insurance, pharmacy, business development, marketing, managed care, Medicaid,… more
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