Insight Health System is a physician-led organization focused on advancing excellence in healthcare and community well-being. Our expertise is in transforming distressed hospitals into stable ...
Insight Health System is a physician-led organization focused on advancing excellence in healthcare and community well-being. Our expertise is in transforming distressed hospitals into stable ...
Insight Health System is a physician-led organization focused on advancing excellence in healthcare and community well-being. Our expertise is in transforming distressed hospitals into stable ...
Insight Health System is a physician-led organization focused on advancing excellence in healthcare and community well-being. Our expertise is in transforming distressed hospitals into stable ...
Medical Assistant
Flint, MI · On-site
$17/hr
Insight Health System is a physician-led organization focused on advancing excellence in healthcare and community well-being. Our expertise is in transforming distressed hospitals into stable ...
Medical Assistant
Flint, MI · On-site
$17/hr
Insight Health System is a physician-led organization focused on advancing excellence in healthcare and community well-being. Our expertise is in transforming distressed hospitals into stable ...
Here at BAYADA Home Health Care, you have the flexibility to choose where you want to work, who you ... Hence, we strongly encourage applications from people with these identities or who are members of ...
Here at BAYADA Home Health Care, you have the flexibility to choose where you want to work, who you ... Hence, we strongly encourage applications from people with these identities or who are members of ...
Home Health Care Aide
Columbus, OH · On-site
$16.50/hr
Home Health Aide - $16.50/hr Location: West Columbus (Client lives with family) Schedule: Monday-Friday | 9:00 AM - 12:00 PM | 15 hours per week Elevate Home Health Care LLC is seeking a dependable ...
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Home Health Care Aide
Columbus, OH · On-site
$16.50/hr
Home Health Aide - $16.50/hr Location: West Columbus (Client lives with family) Schedule: Monday-Friday | 9:00 AM - 12:00 PM | 15 hours per week Elevate Home Health Care LLC is seeking a dependable ...
Home Health Care Patient Coordinator
Southfield, MI · On-site
$20 - $25/hr
Home Health Care Patient Coordinator Accelerated is seeking a compassionate and highly organized ... This position is responsible for coordinating all aspects of patient care, from initial intake and ...
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Home Health Care Patient Coordinator
Southfield, MI · On-site
$20 - $25/hr
Home Health Care Patient Coordinator Accelerated is seeking a compassionate and highly organized ... This position is responsible for coordinating all aspects of patient care, from initial intake and ...
Home Healthcare Aide
Decatur, GA · On-site
$12 - $13/hr
Job Summary We are looking for a Home Care Aide to join our team! You will be directly working with ... Graduated from an accredited Home Health Aide program * High School Diploma or GED * One-year prior ...
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Home Healthcare Aide
Decatur, GA · On-site
$12 - $13/hr
Job Summary We are looking for a Home Care Aide to join our team! You will be directly working with ... Graduated from an accredited Home Health Aide program * High School Diploma or GED * One-year prior ...
Home Healthcare Aide
$14 - $18/hr
Job Summary We are looking for a Home Care Aide to join our team! You will be directly working with ... Graduated from an accredited Home Health Aide program High School Diploma or GED One-year prior ...
Home Healthcare Aide
$14 - $18/hr
Job Summary We are looking for a Home Care Aide to join our team! You will be directly working with ... Graduated from an accredited Home Health Aide program High School Diploma or GED One-year prior ...
Home Healthcare Aide
$12 - $13/hr
Job Summary We are looking for a Home Care Aide to join our team! You will be directly working with ... Graduated from an accredited Home Health Aide program * High School Diploma or GED * One-year prior ...
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Home Healthcare Aide
$12 - $13/hr
Job Summary We are looking for a Home Care Aide to join our team! You will be directly working with ... Graduated from an accredited Home Health Aide program * High School Diploma or GED * One-year prior ...
Home Healthcare Aide
$14 - $18/hr
Job Summary We are looking for a Home Care Aide to join our team! You will be directly working with ... Graduated from an accredited Home Health Aide program High School Diploma or GED One-year prior ...
Home Healthcare Aide
$14 - $18/hr
Job Summary We are looking for a Home Care Aide to join our team! You will be directly working with ... Graduated from an accredited Home Health Aide program High School Diploma or GED One-year prior ...
Registered Nurse Home Healthcare
$45 - $52/hr
Flexible work from home options available. Compensation: $45.00 - $52.00 per hour BE PART OF A GROWING INDUSTRY THAT CHANGES LIVES Inspired by nurses, Boost Home Healthcare makes it easier for ...
Registered Nurse Home Healthcare
$45 - $52/hr
Flexible work from home options available. Compensation: $45.00 - $52.00 per hour BE PART OF A GROWING INDUSTRY THAT CHANGES LIVES Inspired by nurses, Boost Home Healthcare makes it easier for ...
The Home Healthcare Supervisor is responsible for overseeing the daily operations and staffing of our home healthcare team. This position ensures efficient scheduling, accurate payroll processing ...
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The Home Healthcare Supervisor is responsible for overseeing the daily operations and staffing of our home healthcare team. This position ensures efficient scheduling, accurate payroll processing ...
Home Healthcare Scheduler
Ann Arbor, MI · On-site
$17.75 - $23.50/hr
Home Health Care Scheduler - Full-Time Interim Health Care of Washtenaw About the Role: We're looking for someone who thrives in a fast-moving environment and can keep schedules tight, caregivers ...
Home Healthcare Scheduler
Ann Arbor, MI · On-site
$17.75 - $23.50/hr
Home Health Care Scheduler - Full-Time Interim Health Care of Washtenaw About the Role: We're looking for someone who thrives in a fast-moving environment and can keep schedules tight, caregivers ...
Storrs | Home Health Care
Storrs, CT · On-site
Resources A very different home healthcare employer. Recognized for high standards of care ... Be at least 18 years of age Present a letter from a person and/or employer verifying experience.
Storrs | Home Health Care
Storrs, CT · On-site
Resources A very different home healthcare employer. Recognized for high standards of care ... Be at least 18 years of age Present a letter from a person and/or employer verifying experience.
PTA Home Health Care
$50 - $55/day
... in home health care. · Criminal background check & and other state required checks for compliance ... If educated outside the United States or trained in the United States military, graduated from an ...
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PTA Home Health Care
$50 - $55/day
... in home health care. · Criminal background check & and other state required checks for compliance ... If educated outside the United States or trained in the United States military, graduated from an ...
Home Health Care
Baltimore, MD · On-site
$12 - $15/hr
must have 2 years in home care Up to date CNA CPR , Covid -19 Vaccination card Must Have Reliable Transportation Company Description Terry's Helping Hand's We are Built on Giving EXCELLENT Care . We ...
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Home Health Care
Baltimore, MD · On-site
$12 - $15/hr
must have 2 years in home care Up to date CNA CPR , Covid -19 Vaccination card Must Have Reliable Transportation Company Description Terry's Helping Hand's We are Built on Giving EXCELLENT Care . We ...
Home Health Care RN
Sagamore Beach, MA · On-site
$27 - $32/hr
Per-Diem Home Health Care Registered Nurse Location: PLYMOUTH AREA Join our compassionate and dedicated team providing professional care to patients in the comfort of their homes. We are looking for ...
Home Health Care RN
Sagamore Beach, MA · On-site
$27 - $32/hr
Per-Diem Home Health Care Registered Nurse Location: PLYMOUTH AREA Join our compassionate and dedicated team providing professional care to patients in the comfort of their homes. We are looking for ...
Occupational Therapist Home Healthcare
Columbia Falls, MT · On-site
$38.75 - $49/hr
Degree from an accredited Occupational Therapy program * Minimum 1 year experience in home health, skilled nursing, rehab, or acute care (preferred) * Knowledge of Medicare guidelines, OASIS ...
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Occupational Therapist Home Healthcare
Columbia Falls, MT · On-site
$38.75 - $49/hr
Degree from an accredited Occupational Therapy program * Minimum 1 year experience in home health, skilled nursing, rehab, or acute care (preferred) * Knowledge of Medicare guidelines, OASIS ...
Home Health Care RN
Weymouth, MA · On-site
$27 - $32/hr
Per-Diem Home Health Care Registered Nurse Location: BROCKTON AREA Join our compassionate and dedicated team providing professional care to patients in the comfort of their homes. We are looking for ...
Home Health Care RN
Weymouth, MA · On-site
$27 - $32/hr
Per-Diem Home Health Care Registered Nurse Location: BROCKTON AREA Join our compassionate and dedicated team providing professional care to patients in the comfort of their homes. We are looking for ...
Health Care Aide - Home Care
North Salt Lake, UT · On-site
$23.62 - $28.71/hr
The amazing Home Care team in St. Paul has an opening for a Health Care Aide (HCA). This role is ... Must provide a confirmation letter as proof of enrolment from the Directory at Nursing students ...
Health Care Aide - Home Care
North Salt Lake, UT · On-site
$23.62 - $28.71/hr
The amazing Home Care team in St. Paul has an opening for a Health Care Aide (HCA). This role is ... Must provide a confirmation letter as proof of enrolment from the Directory at Nursing students ...
From Home Insight Healthcare information

Full-time
Medical, Dental, Vision, Life, Retirement, PTO
Posted 25 days ago
Insight Enterprises rating
8.6
Based on 18 frontline employees who took The Breakroom Quiz
25th of 203 rated it services
Job description
We are seeking a proactive, relationship-driven PBM Partnerships amp; Payer Relations Manager to serve as the primary point of contact for Pharmacy Benefit Managers (PBMs), third-party administrators (TPAs), brokers, and self-funded employer groups. This role is responsible for building new partnerships, strengthening existing relationships, supporting contract execution, ensuring operational accuracy, and driving network growth across all payer and PBM channels. The ideal candidate excels at communication, problem-solving, and business development within the pharmacy or healthcare benefits ecosystem.
- Comprehensive health, dental, and vision insurance
- Paid time off: vacation, holidays, and sick leave
- 401(k) with employer match (immediate vesting; eligibility begins after 3 months)
- Employer - paid short - and long - term disability, basic life insurance
- Voluntary coverages: accident, critical illness, hospital indemnity, AD amp;D, etc.
Key Responsibilities:
PBM Partnership Management
- Serve as the main liaison for all PBM partners, contractors, TPAs, and associated vendors.
- Manage onboarding, implementations, and ongoing communication to ensure alignment and strong operational performance.
- Oversee contract execution, version control, and escalation resolution with external partners.
- Proactively step in to assist with prior authorizations or operational duties as needed to ensure exceptional service continuity.
- Maintain a clear understanding of PBM reimbursement strategies, plan designs, MAC pricing, and specialty pharmacy dynamics.
- Step in to assist with PAs or operations during high-volume periods or staffing gaps.
Self-Funded Employer Network Development
- Build new relationships with self-funded employers, brokers, benefits consultants, and employer coalitions.
- Identify opportunities for employers to utilize the pharmacy as a preferred or direct-to-employer solution (specialty savings, infusion savings, carve-outs).
- Present pharmacy value propositions, cost-savings models, and service offerings to employer groups.
- Support the execution of direct-to-employer agreements and develop customized employer workflows.
- Drive expansion into new PBM networks, payer groups, and employer health plans.
- Research and pursue opportunities to improve reimbursement rates or negotiate favorable contract terms.
- Track market trends, competitive pricing, and plan changes influencing pharmacy performance.
- Strengthen ties with existing PBM and payer partners to secure long-term relationships.
Operational amp; Contract Coordination
- Troubleshoot operational issues, adjudication errors, reimbursement discrepancies, and network constraints.
- Collaborate with internal teams (legal, finance, operations, pharmacy) to ensure contractual accuracy and workflow alignment.
- Maintain oversight of contract renewals, amendments, compliance obligations, and key dates.
- Support renegotiation efforts by preparing comparisons, contract reviews, and partner summaries.
Performance Monitoring amp; Reporting
- Track reimbursement patterns, adjudication behaviors, specialty margins, and PBM performance metrics.
- Generate internal reporting to evaluate partnership effectiveness and financial outcomes.
- Identify opportunities to optimize pricing strategies, improve patient access, and enhance profitability.
Relationship Building amp; Strategic Development
- Cultivate strong, trust-based relationships with PBM executives, employer decision-makers, consultants, and industry partners.
- Represent the organization at meetings, conferences, and strategic discussions.
- Identify emerging opportunities for collaboration, market expansion, or product/service enhancement.
Required Qualifications
- Bachelor’s degree in Business, Healthcare Administration, Pharmacy, or a related field.
- Experience working with PBMs, payers, networks, benefits administrators, or pharmacy operations.
- Strong communication, negotiation, and relationship-management skills.
- Ability to manage contracts, escalations, timelines, and multi-stakeholder relationships.
- Strong analytical thinking, problem-solving skills, and organizational abilities.
Preferred Qualifications
- Prior experience working directly with PBMs, TPAs, or self-funded employer groups.
- Experience in specialty pharmacy, infusion services, or pharmacy network contracting.
- Working knowledge of claim adjudication, reimbursement structures, MAC lists, spread pricing, and DIR fee models.
- Experience building direct-to-employer pharmacy programs or benefit carve-out models.
- Familiarity with value-based pharmacy programs, outcomes reporting, and data-driven performance metrics.
- Strong understanding of healthcare contracting, payer policies, and benefits administration.
- Ability to interpret contract terms, fee schedules, and reimbursement methodologies.
- Experience presenting pharmacy solutions or savings programs to employers, payers, or consultants.
- Existing relationships with PBMs, benefit brokers, employer groups, or industry partners is a major plus.
Insight is an equal opportunity employer and values workplace diversity!
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