... pharmacy benefit audit or b) claim adjudication research experience on one or more PBM platforms · Working knowledge of the PBM industry and pharmacy benefit claims Desired Skills: · Proficient in ...
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... pharmacy benefit audit or b) claim adjudication research experience on one or more PBM platforms · Working knowledge of the PBM industry and pharmacy benefit claims Desired Skills: · Proficient in ...
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... pharmacy benefit audit or b) claim adjudication research experience on one or more PBM platforms · Working knowledge of the PBM industry and pharmacy benefit claims Desired Skills: · Proficient in ...
... pharmacy benefit audit or b) claim adjudication research experience on one or more PBM platforms · Working knowledge of the PBM industry and pharmacy benefit claims Desired Skills: · Proficient in ...
Quick apply
... pharmacy benefit audit or b) claim adjudication research experience on one or more PBM platforms · Working knowledge of the PBM industry and pharmacy benefit claims Desired Skills: · Proficient in ...
Columbus, OH · Remote
$24/hr
... analytical skills, Intermediate typing/keyboarding skills. * Behavior Competencies * Required ... We are seeking Pharmacy Benefit Verification Specialist s who go above and beyond for our patients ...
Columbus, OH · Remote
$24/hr
... analytical skills, Intermediate typing/keyboarding skills. * Behavior Competencies * Required ... We are seeking Pharmacy Benefit Verification Specialist s who go above and beyond for our patients ...
Saint Louis, MO · On-site
$24/hr
... analytical skills, Intermediate typing/keyboarding skills. * Behavior Competencies * Required ... We are seeking Pharmacy Benefit Verification Specialist s who go above and beyond for our patients ...
Saint Louis, MO · On-site
$24/hr
... analytical skills, Intermediate typing/keyboarding skills. * Behavior Competencies * Required ... We are seeking Pharmacy Benefit Verification Specialist s who go above and beyond for our patients ...
The Pharmacy Business Analyst for our Medicare Advantage Plan will play a critical role in analyzing pharmacy data and supporting the development and implementation of pharmacy benefit strategies.
The Pharmacy Business Analyst for our Medicare Advantage Plan will play a critical role in analyzing pharmacy data and supporting the development and implementation of pharmacy benefit strategies.
The Pharmacy Business Analyst for our Medicare Advantage Plan will play a critical role in analyzing pharmacy data and supporting the development and implementation of pharmacy benefit strategies.
The Pharmacy Business Analyst for our Medicare Advantage Plan will play a critical role in analyzing pharmacy data and supporting the development and implementation of pharmacy benefit strategies.
Hartford, CT · On-site
$24/hr
... analytical skills, Intermediate typing/keyboarding skills. * Behavior Competencies * Required ... We are seeking Pharmacy Benefit Verification Specialist s who go above and beyond for our patients ...
Hartford, CT · On-site
$24/hr
... analytical skills, Intermediate typing/keyboarding skills. * Behavior Competencies * Required ... We are seeking Pharmacy Benefit Verification Specialist s who go above and beyond for our patients ...
Columbus, OH · On-site
$24/hr
... analytical skills, Intermediate typing/keyboarding skills. * Behavior Competencies * Required ... We are seeking Pharmacy Benefit Verification Specialist s who go above and beyond for our patients ...
Columbus, OH · On-site
$24/hr
... analytical skills, Intermediate typing/keyboarding skills. * Behavior Competencies * Required ... We are seeking Pharmacy Benefit Verification Specialist s who go above and beyond for our patients ...
Indianapolis, IN · Remote
$24/hr
... analytical skills, Intermediate typing/keyboarding skills. * Behavior Competencies * Required ... We are seeking Pharmacy Benefit Verification Specialist s who go above and beyond for our patients ...
Indianapolis, IN · Remote
$24/hr
... analytical skills, Intermediate typing/keyboarding skills. * Behavior Competencies * Required ... We are seeking Pharmacy Benefit Verification Specialist s who go above and beyond for our patients ...
Pittsburgh, PA · On-site
$24/hr
... analytical skills, Intermediate typing/keyboarding skills. * Behavior Competencies * Required ... We are seeking Pharmacy Benefit Verification Specialist s who go above and beyond for our patients ...
Pittsburgh, PA · On-site
$24/hr
... analytical skills, Intermediate typing/keyboarding skills. * Behavior Competencies * Required ... We are seeking Pharmacy Benefit Verification Specialist s who go above and beyond for our patients ...
Hartford, CT · Remote
$24/hr
... analytical skills, Intermediate typing/keyboarding skills. * Behavior Competencies * Required ... We are seeking Pharmacy Benefit Verification Specialist s who go above and beyond for our patients ...
Hartford, CT · Remote
$24/hr
... analytical skills, Intermediate typing/keyboarding skills. * Behavior Competencies * Required ... We are seeking Pharmacy Benefit Verification Specialist s who go above and beyond for our patients ...
Burlington, VT · On-site
$24/hr
... analytical skills, Intermediate typing/keyboarding skills. * Behavior Competencies * Required ... We are seeking Pharmacy Benefit Verification Specialist s who go above and beyond for our patients ...
Burlington, VT · On-site
$24/hr
... analytical skills, Intermediate typing/keyboarding skills. * Behavior Competencies * Required ... We are seeking Pharmacy Benefit Verification Specialist s who go above and beyond for our patients ...
Pittsburgh, PA · Remote
$24/hr
... analytical skills, Intermediate typing/keyboarding skills. * Behavior Competencies * Required ... We are seeking Pharmacy Benefit Verification Specialist s who go above and beyond for our patients ...
Pittsburgh, PA · Remote
$24/hr
... analytical skills, Intermediate typing/keyboarding skills. * Behavior Competencies * Required ... We are seeking Pharmacy Benefit Verification Specialist s who go above and beyond for our patients ...
Burlington, VT · Remote
$24/hr
... analytical skills, Intermediate typing/keyboarding skills. * Behavior Competencies * Required ... We are seeking Pharmacy Benefit Verification Specialist s who go above and beyond for our patients ...
Burlington, VT · Remote
$24/hr
... analytical skills, Intermediate typing/keyboarding skills. * Behavior Competencies * Required ... We are seeking Pharmacy Benefit Verification Specialist s who go above and beyond for our patients ...
Indianapolis, IN · On-site
$24/hr
... analytical skills, Intermediate typing/keyboarding skills. * Behavior Competencies * Required ... We are seeking Pharmacy Benefit Verification Specialist s who go above and beyond for our patients ...
Indianapolis, IN · On-site
$24/hr
... analytical skills, Intermediate typing/keyboarding skills. * Behavior Competencies * Required ... We are seeking Pharmacy Benefit Verification Specialist s who go above and beyond for our patients ...
Saint Louis, MO · Remote
$24/hr
... analytical skills, Intermediate typing/keyboarding skills. * Behavior Competencies * Required ... We are seeking Pharmacy Benefit Verification Specialist s who go above and beyond for our patients ...
Saint Louis, MO · Remote
$24/hr
... analytical skills, Intermediate typing/keyboarding skills. * Behavior Competencies * Required ... We are seeking Pharmacy Benefit Verification Specialist s who go above and beyond for our patients ...
$14.75 - $20/hr
Performs benefit authorizations and modification as required and approved by client * Maintain up ... Possess strong analytical skills and independent thinking/creativity. * Ability to be flexible and ...
$14.75 - $20/hr
Performs benefit authorizations and modification as required and approved by client * Maintain up ... Possess strong analytical skills and independent thinking/creativity. * Ability to be flexible and ...
Entry Level Pharmacy Technician-Immediate Joining! Job Overview We are hiring entry-level Pharmacy ... Pay and Benefits The pay range for this position is $19.00 - $19.00/hr. Eligibility requirements ...
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Entry Level Pharmacy Technician-Immediate Joining! Job Overview We are hiring entry-level Pharmacy ... Pay and Benefits The pay range for this position is $19.00 - $19.00/hr. Eligibility requirements ...
Southfield, MI · On-site
$14.75 - $20/hr
Performs benefit authorizations and modification as required and approved by client * Maintain up ... Possess strong analytical skills and independent thinking/creativity. * Ability to be flexible and ...
Southfield, MI · On-site
$14.75 - $20/hr
Performs benefit authorizations and modification as required and approved by client * Maintain up ... Possess strong analytical skills and independent thinking/creativity. * Ability to be flexible and ...
$14.75 - $20/hr
Performs benefit authorizations and modification as required and approved by client * Maintain up ... Possess strong analytical skills and independent thinking/creativity. * Ability to be flexible and ...
Quick apply
$14.75 - $20/hr
Performs benefit authorizations and modification as required and approved by client * Maintain up ... Possess strong analytical skills and independent thinking/creativity. * Ability to be flexible and ...
$38.5K - $45.3K
5% of jobs
$45.3K - $52K
12% of jobs
$55.8K is the 25th percentile. Wages below this are outliers.
$52K - $58.8K
15% of jobs
$58.8K - $65.6K
13% of jobs
The median wage is $68.7K / yr.
$65.6K - $72.4K
13% of jobs
$72.4K - $79.1K
16% of jobs
$80.5K is the 75th percentile. Wages above this are outliers.
$79.1K - $85.9K
12% of jobs
$85.9K - $92.7K
7% of jobs
$92.7K - $99.5K
2% of jobs
$99.5K - $106.2K
4% of jobs
$106.2K - $113K
2% of jobs
$38.5K
$72.3K
$113K

Full-time
Re-posted 20 days ago
Specific job functions include:
· Review and understand PBM contracts for all relevant pricing terms
· Review and understand plan design documents provided by PBM or client
· Utilize company’s proprietary Compliance Model
· Calculate client contractual financial guarantees, admin fees, rebates and other terms as required by client contract
· Assemble audit reports and summarize findings
· Document all potential issues and track decisions
· Collaborate with account management and pharmacy consultants to discuss results with clients and vendors
· Provide documentation during follow-up negotiations and discussions
· Work with IT to further develop Compliance Model logic and capabilities
· Assist in other financial projects as needed
Requirements:
· Bachelor’s degree in Business, Finance, or other health related field
· At least 3 years of either a) pharmacy benefit audit or b) claim adjudication research experience on one or more PBM platforms
· Working knowledge of the PBM industry and pharmacy benefit claims
Desired Skills:
· Proficient in Microsoft Office, with extensive experience working with Excel
· Basic SQL query building
· Strong verbal and written communication skills
· Detail-oriented
· Solid, independent worker (this position will likely be based in the applicant’s home)
· Pharmacy Technician Certification (preferred)
Leading specialty benefits management company in Puerto Rico and South Florida. Our innovative care management model integrates the needs of providers, payors and members to ensure the delivery of high quality, cost effective care while realizing substantial millions of dollars savings that keep the cost of healthcare down.
We are building a model for managing care delivery that embodies traditional values, promises reliability, and embraces flexibility and technology. Through our experience in the healthcare industry, the company aims to improve healthcare outcomes, achieve cost savings and serve as a single point of contact to move into value-based care.