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The PBM, in consultation with others, develops annual revenue & expense budgets for Parish operations, SSPP school, SSPP Cemetery, SSPP religious education and SSPP Parish outreach. Brief Job Description : The Parish Business Manager (PBM) is responsible for the day-to-day financial and operating activities of Saints Peter & Paul Parish (SSPP.
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The PBM Business Integration Specialist will provide expertise and business support to the Pharmacy and Ancillary Services Business Unit in the development and implementation of the Medicaid Enterprise Modular Pharmacy Business Management (PBM) Solution.
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Utilize experience with Applications in Claim Adjudication: RxClaim (PBM), Facets, Claim system, AEPPYS, CRS; QA Methodologies: SDLC waterfall model, Estimation, timeline and planning; QA Tools: HP - ALM, HP - UFT, Clear Quest, JIRA; iSeries and COBOL; Databases: DB2 and IDBMS; SOAP UI; Functional testing, Regression testing, Smoke testing, Automation testing; E2E testing; Managing and leading teams in Onsite - offshore model.
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Key National Payer/PBM accounts include United Health Group, OptumRx, Aetna, CVS, Cigna, Prime, Express Scripts, Elevance. This includes but is not limited to Managed Care Organizations (MCO), Specialty Pharmacies (SP), Pharmaceutical Benefit Managers (PBM), and Integrated Delivery Networks (IDN.
$209,000 - $255,000 a yearFull-timeExpandApply NowActive JobUpdated 1 days ago - UpvoteDownvoteShare Job
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Act as business owner of the contract between Amgen and its customer, specifically owning the contracting strategy and execution of one of the Big 3 (“Mega”) managed care PBM/GPO customers. Act as business owner of the contract between Amgen and its customer, specifically owning the contracting strategy and execution of one of the Big 3 (“Mega”) managed care PBM/GPO customers.
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Collaborate internally across Accredo Specialty Pharmacy, Care Coordination, eviCore Medical Benefit Management, Express Scripts PBM, and Cigna Payer Solutions teams and related solutions to maximize value to the client/prospect.
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Reporting directly to the Senior Vice President, the National Account Director will be responsible for establishing and nurturing strategic relationships with OptumRx/United Healthcare benefit management (PBM) company to ensure market access for Sequel's products.
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3+ years of thorough understanding of Market Access (i.e., Medicare, FFS, Medicare Advantage, Medicaid, Commercial Payer Landscape, Reimbursement, IRA, PBM and Quality Measures). The Market Access Training Manager will be responsible for creation of role-specific training for new hire on-boarding, account management and other identified continuous training for Market Access Teams, (i.e., Payer Team - RAMs, NAMs, Health Systems, Trade, GPO/SP, Contracting & Pricing and emerging roles.
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Experience in PBM, Managed Care, or VA Veterans Hospital. Line Staffing Solutions is hiring several Pharmacists with Prior Authorization experience (in a managed care or PBM environment) for full-time opportunities with a Fortune 500 company.
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Sequel Med Tech is seeking a dynamic and experienced National Account Director to join our Market Access, Sales, and Government Affairs team. Demonstrated success negotiating with OptumRx/United Healthcare required.
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Oversees, monitors, and assists with the management of psychopharmacology pharmacy benefits manager (PBM) activities, including the establishment of prior authorization, clinical appropriateness of use, and step therapy requirements for the use of stimulants and antipsychotics for all Members; consultations and clinical guidance for contracted primary care Providers (PCPs) treating behavioral health-related concerns not requiring referral to behavioral health specialists.
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PBM Pharmacy Benefits Manager / Should have healthcare Specialty Pharmacy / Mail order Pharmacy project experience. PBM Pharmacy Benefits Manager / Should have healthcare Specialty Pharmacy / Mail order Pharmacy project experience.
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Leads BH policy development in Virginia, driving implementation, oversight, and accountability for both Humana internal and external stakeholders including but not limited to the Department of Virginia Medical Assistance (DMAS), Department of Behavioral Health and Developmental Services (DBHDS) and the Virginia Department of Health (VDH.
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Lead a lumber maintenance millwright team to safely work in an SIF-free (Severe Injuries or Fatalities), continuous manufacturing environment consistent with PBM® Philosophy while meeting Facility Goals and Vision.
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Experience in healthcare or managed care, which may include PBM, pharma, retail/specialty pharmacy, hospital, market access, account management, or health plan experience. 3+ years ofexperience leading large, cross-functional projectswithin healthcare/PBM, account services, customer service, or related industry.
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