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$95k - $135k
...role, you’ll be responsible for creating data analyses that demonstrate our company’s impact to clients and strategic partners in the PBM space. You will support the development and execution of analytics, provide data-driven strategic insights, and create customized...SuggestedFull timeWork experience placementNight shift$100k - $125k
...services and building strong, long-lasting relationships with our valued clients. The Clinical Pharmacist is the clinical voice of Pulse PBM, Revive Health's pharmacy benefit management business. This role partners with plan sponsors, brokers, and Revive pharmacy leadership...Suggested- ...Pharmacy Services, the Managed Care Pharmacist is primarily responsible for all aspects of implementation of the Pharmacy Benefit Manager (PBM), brokering communication, ensuring execution of desired plan benefit design, and collaborating with key stakeholders, clients, and...SuggestedFull timeWork at officeShift work
- ...URGENT HIRING – SENIOR PRODUCT MANAGER | HEALTHCARE / PBM Location: Remote We are looking for strong Senior Product Manager profiles with extensive Healthcare domain experience. PBM experience is preferred/secondary. Must-Have Experience: 8+ years of IT...SuggestedRemote jobContract workTemporary work
- ...listed on behalf of a partner company, which manages all applications and next steps. Our partner is looking for a Data Analyst III, PBM Client Success based in the United States. We are seeking an experienced, data-driven analyst to transform complex pharmacy benefits...SuggestedFull timeRemote work
$90.9k - $129.9k
...company that values your contributions and puts a premium on work flexibility, learning, and career development. Summary As a PBM / Healthcare Manager at Gainwell, you will lead quality assurance efforts for a complex Fraud, Waste, and Abuse (FWA) solution, ensuring...SuggestedFull timeRemote workFlexible hours- ...years of experience in program coordination, vendor management, strategic partnerships, or product operations, preferably in healthcare, PBM, or managed care ~ Demonstrated ability to communicate effectively with clients, vendor partners, and cross-functional...SuggestedFull timeRemote work
$160k - $190k
...ABOUT THE ROLE: The RVP, PBM Enterprise Sales is a member of the Rightway Commercial team, reporting into the VP, Head of PBM Enterprise. Our innovative, full-stack pharmacy benefit management (PBM) offering represents an important growth area for Rightway. Through...SuggestedFull timeContract workWork at officeNight shift- ...Health Plan Finance Leaders - Paid Research Study (PBM Decisions) is a remote clinical-review track for evaluating AI outputs that touch clinical review. Reviewers grade differential reasoning, dosing logic, and guideline adherence; flag patient-safety issues; and document...SuggestedRemote jobFor contractors10 hours per week
$46.99k - $122.4k
...part of something bigger - helping to simplify health care one person, one family and one community at a time. The Senior Analyst, PBM Contract Manager role applies complex financial, contractual, and business strategies to large, high-impact agreements negotiated...SuggestedHourly payFull timeContract workTemporary workWork experience placementWork at officeLocal area$69.4k - $99.2k
...premium on work flexibility, learning, and career development. Summary As a Senior Business Analyst - Pharmacy Benefit Management (PBM) at Gainwell, you can contribute your skills as we harness the power of technology to help our clients improve the health and well-...SuggestedFull timeRemote workFlexible hours$175.1k - $334.75k
...health care one person, one family and one community at a time. Position Summary As a Senior Legal Counsel, Pharmacy Benefit Manager (PBM) you will provide legal guidance, interpretation, advice and recommendations for action to internal stakeholders and senior/executive...SuggestedHourly payFull timeTemporary workLocal area- ...what they're doing! We're committed to bringing passion and customer focus to the business. The Account Coordinator supports the PBM Commercial Account Management team serving large commercial clients by coordinating day-to-day client support and helping ensure timely...SuggestedWork at officeRemote workHome office
- ...and the greatness you can bring to our teams, please submit your resume to MedImpact, is a privately-held pharmacy benefit manager (PBM) headquartered in San Diego, California. Our solutions and services positively influence healthcare outcomes and expenditures,...SuggestedFull timeRemote workMonday to FridayNight shiftWeekend work
- ...TrueScripts Management Services is a pharmacist-founded, fully transparent Prescription Benefit Manager that has been revolutionizing the PBM industry since 2014. Our mission is to build lasting relationships by providing prescription benefit expertise at a personal and...SuggestedWork at office
- ...audiences. Results oriented and ability to juggle multiple concurrent projects with changing priorities and deadlines Familiarity with PBM business model (plans, programs, and practices) as well as pharmaceutical practices (nomenclature, medications) helpful. Reasoning...Work experience placementWork at officeLocal areaRemote workMonday to FridayNight shiftWeekend work
- ...control of their pharmacy benefits, healthcare outcomes, and financial results. We place more emphasis on member care than any other PBM by focusing on health outcomes first. Our pharmacists and clinicians are at the center of everything we do―and our population health...Work at officeRemote work
$85.39k - $116.98k
...99/277CA transactions Knowledge of HIPAA compliance requirements in cloud data architecture Experience with healthcare payer/PBM systems, clearinghouses, or pharmacy operations AWS certification in a bonus Formal Education Bachelor’s degree in Computer Science...Full timeRemote work$85.39k - $116.98k
...transactions such as 837, 834, 835, 277, 270/271, 278, and 999. Familiarity with EDIFECS, healthcare payer or pharmacy benefit management (PBM) systems, clearinghouses, and pharmacy operations is an advantage. Healthcare data security: Understanding of HIPAA requirements...Full timeRemote work$26.04 per hour
...end-to-end prescribing and prior authorization operations. This role is responsible for navigating complex Pharmacy Benefit Manager (PBM) criteria, handling complex member escalations, and ensuring members gain timely access to prescribed therapies. We are seeking a proactive...Seasonal workLocal areaRemote workVisa sponsorshipWork visaMonday to Friday$300k - $420k
...Finance on gross-to-net (GTN) assumptions, forecasts, and net revenue. Negotiate strategically — securing differentiated payer and PBM positioning without defaulting to price concessions — and develop innovative contracting models (e.g., value-based, outcomes-based,...Contract workTemporary workWork at officeRemote workShift work$162.9k - $271.5k
...program, including the impact of maximizers and accumulators Verify coverage for the product and for required baseline tests across both PBM and major medical insurance for VFM Oversee the entire prior authorization process, including submission and verification with both...Permanent employmentWork experience placementInterim roleH1bWork at officeLocal areaRemote workVisa sponsorshipWork visaRelocation package$130.3k - $260.59k
...community at a time. Position Summary: CVS Health has an exciting opportunity for an in-house counsel position on the company's PBM client contracting team. In this role, you will support the team's work on negotiating non-disclosure agreements with clients, consultants...Hourly payFull timeTemporary workLocal area$147.4k - $279.68k
...Experience: 7+ years of health actuarial experience, with at least 4 years focused specifically on pharmacy benefits, drug pricing, or PBM economics. Technical Skills & Programming Claims data: Experience working with medical and pharmacy data. Technical knowledge of...Full timeContract workTemporary workWork experience placementWork at officeRemote workFlexible hours$80.9k - $110.3k
...in healthcare or managed care analytics is desirable, particularly in Medicare Part D, pharmacy claims, pharmacy benefit management (PBM), CMS demonstration programs, or regulatory reporting. Education and Certifications: A master's degree in Analytics, Data Science...Temporary workRemote work$65.2k - $131.91k
...inclusion, social impact, and sustainability. What this position entails By leveraging our relationships with retail pharmacy chains, PBM’s, and data clearinghouses, Milliman IntelliScript assesses pharmacy and other types of data on an identified and de-identified basis...Full timeTemporary workWork experience placementRemote workFlexible hours$80.08k - $104k
...Express IDE. • Experience working within a Red Hat Linux environment. • Experience developing or supporting a Pharmacy Benefit Management (PBM) system. • Experience with production support activities and monitoring. • Flexibility to work morning or afternoon shifts based on...Remote workWork from homeFlexible hoursDay shiftAfternoon shift$63.65k - $92.57k
...Monitor pharmacy operational processes and identify and advance opportunities to improve efficiency, accuracy, and quality. -Monitor PBM operational performance and hold vendors accountable for timely, accurate deliverables and service standards. -Coordinate issue...Full timeWork at officeRemote workMonday to FridayFlexible hoursShift work$21.2 - $33.03 per hour
...calling with questions and/or problems pertaining to the pharmacy benefit. Monitor and troubleshoot the Pharmacy Benefit Management (PBM) and other pharmacy interfaces for eligibility, claims, and formulary issues. Conduct testing of the interfaces as necessary. Monitor...Work at officeImmediate startRemote workWork from homeHome officeAfternoon shift$235k - $270k
...account. The Director will develop, execute, and manage strategic relationships with key stakeholders across the Emisar (GPO) and Optum (PBM) books of business, along with their affiliated Commercial and Medicare plan stakeholders, to secure access to the BBIO portfolio of...Full timeContract workWork at officeRemote workFlexible hours