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Draft, negotiates and reviews market access related agreements, including: PBM agreements, GPO agreements, Specialty Pharmacy agreements, wholesaler agreements, discount and rebate agreements, distribution agreements, innovative/value-based agreements, market research agreements, vendor agreements, and service agreements.
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Generate insights and develop KPIs as part of US market access readiness launch activities, including evaluating in-market analogs pricing & contracting environment, payer/PBM landscape, clinic/hospital economics, employer groups, value-based agreements and other landscape activities.
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Draft, negotiate and review commercial agreements, including PBM, GPO, Medicare/Medicaid, payer, formulary, specialty pharmacy, wholesaler, discount and rebate, distribution, vendor and supplier contracts related to reimbursed prescription products for the treatment of various dermatological skin conditions.
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Experience should include strong understanding of Managed Care, Medicare Part B, GPO, PBM and other Payer segments. This person should be familiar with and able to discuss different segments of market access, contracting strategies and tactics, understand the various types of managed care contracting and be able to determine the potential value of a contracting opportunity.
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Lead the delivery of therapeutic area specific analytical insights in response to market access landscape, issues and trends. As a member of Takeda Oncology, as a Director, your work will contribute to our bold, inspiring vision: We aspire to cure cancer.
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PBM Pricing Strategy Director. is responsible for the analysis and development of the Pharmacy Benefits Manager (PBM) pricing strategy. Requires a BA/BS in Finance or related field and a minimum of 10 years of experience with a PBM, pricing, data analysis; or any combination of education and experience, which would provide an equivalent background.
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Experience with reporting tools (Tableau, QlikView) is required. Conduct investigative analytics to validate and/ or quantify market access-related phenomenon related to competitive or customer tactics.
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Call insurances to obtain patient PBM coverage information Accurate data entry into system Document collection and storage Contact doctor offices to collect and request prescriptions, authorizations, clinical notes, and lab results.
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Experience in Healthcare analytics (preferably PBM Analytics), Clinical Outcomes, Real World Evidence, Care Management Programs. Deep healthcare data experience (e.g., PBM experience, Provider Networks, Billing, Medical and Pharmacy claims), statistical analysis experience, and an understanding of all the associated clinical, utilization and financial levers.
$102,000 - $170,000 a yearFull-timeWork from homeExpandApply NowActive JobUpdated 5 days ago - UpvoteDownvoteShare Job
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Amazon Pharmacy is seeking a driven, talented, and experienced account manager to define and manage critical role relationships with Health Plan and PBM Partners. 1+ years experience with a mail-order Pharmacy.
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Provide the commercial, market access, and contracting analytics for all inline and new products and be charged with taking strategic portfolio approach to the disciplines. U.S.based employees are also eligible to receive, per calendar year, up to 80 hours of sick time, and new hires are eligible to accrue up to 120 hours of paid vacation.
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Experience in Pharmacy Benefit Management (PBM) or healthcare industry. Sr. Business Analyst - Remote. We help people get the medicine they need to feel better and live well. Experience in data visualization and database queries is highly preferred.
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Experience in a managed care setting, either from the provider, the payer, or the PBM side of the industry, is preferred. Graduate study in a business, public health, or health policy field will be favorably considered.
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Will process the formulary changes from the Tricare Beneficiary Advisory Panel minutes for USFHP members and coordinate medication coding updates in conjunction with Point 32 Health to ensure proper formulary drug coding through our PBM. Will be the liaison with clinician offices to facilitate approval of medications through prior authorizations.
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Process pharmacy authorizations utilizing PBM real time online claims adjudication software. Review and interpret member’s eligibility, claim history, and Pharmacy Program information using the PBM claims software to provide information to both internal and external clients via telephone or email.
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