Specific job functions include: · Review and understand PBM contracts for all relevant pricing ... and pharmacy consultants to discuss results with clients and vendors · Provide documentation ...
Quick apply
Specific job functions include: · Review and understand PBM contracts for all relevant pricing ... and pharmacy consultants to discuss results with clients and vendors · Provide documentation ...
Quick apply
Specific job functions include: · Review and understand PBM contracts for all relevant pricing ... and pharmacy consultants to discuss results with clients and vendors · Provide documentation ...
Specific job functions include: · Review and understand PBM contracts for all relevant pricing ... and pharmacy consultants to discuss results with clients and vendors · Provide documentation ...
Quick apply
Specific job functions include: · Review and understand PBM contracts for all relevant pricing ... and pharmacy consultants to discuss results with clients and vendors · Provide documentation ...
Orlando, FL · On-site
$13 - $14.50/hr
Connect with one of our Professional Recruiting Consultants today to see how a conversation can ... Enter and document coverage determination request decision into the PBM system and notify providers ...
Orlando, FL · On-site
$13 - $14.50/hr
Connect with one of our Professional Recruiting Consultants today to see how a conversation can ... Enter and document coverage determination request decision into the PBM system and notify providers ...
Tampa, FL · On-site
$71K - $97K/yr
... consultative support to sales and account management personnel throughout the sale, implementation and renewal of MMA Rx Solutions Reviews all draft PBM contracts to ensure pricing and terms match ...
Tampa, FL · On-site
$71K - $97K/yr
... consultative support to sales and account management personnel throughout the sale, implementation and renewal of MMA Rx Solutions Reviews all draft PBM contracts to ensure pricing and terms match ...
$13 - $14.50/hr
Connect with one of our Professional Recruiting Consultants today to see how a conversation can ... the PBM system and notify providers and/or members Respond to client inquiries regarding ...
$13 - $14.50/hr
Connect with one of our Professional Recruiting Consultants today to see how a conversation can ... the PBM system and notify providers and/or members Respond to client inquiries regarding ...
Orlando, FL · On-site
$16/hr
Connect with one of our Professional Recruiting Consultants today to see how a conversation can ... the PBM system and notify providers and/or members Respond to client inquiries regarding ...
Orlando, FL · On-site
$16/hr
Connect with one of our Professional Recruiting Consultants today to see how a conversation can ... the PBM system and notify providers and/or members Respond to client inquiries regarding ...
Present and explain complex pharmacy benefit financial strategies such as PBM pricing models ... gained in a consulting, brokerage, pharmacy benefit manager or carrier environment * Strong ...
New
Present and explain complex pharmacy benefit financial strategies such as PBM pricing models ... gained in a consulting, brokerage, pharmacy benefit manager or carrier environment * Strong ...
New
Tampa, FL · On-site
$121K - $161K/yr
Present and explain complex pharmacy benefit financial strategies such as PBM pricing models ... gained in a consulting, brokerage, pharmacy benefit manager or carrier environment * Strong ...
Tampa, FL · On-site
$121K - $161K/yr
Present and explain complex pharmacy benefit financial strategies such as PBM pricing models ... gained in a consulting, brokerage, pharmacy benefit manager or carrier environment * Strong ...
$16.75 - $20.50/hr
Connect with one of our Professional Recruiting Consultants today to see how a conversation can ... the PBM system and notify providers and/or members Respond to client inquiries regarding ...
$16.75 - $20.50/hr
Connect with one of our Professional Recruiting Consultants today to see how a conversation can ... the PBM system and notify providers and/or members Respond to client inquiries regarding ...
Tallahassee, FL · On-site
$54.30 - $159.12/hr
... PBM financial, pricing, and analytics that will help to drive business results. Responsible for providing guidance and direction to internal constituents and consulting team members as required in ...
Tallahassee, FL · On-site
$54.30 - $159.12/hr
... PBM financial, pricing, and analytics that will help to drive business results. Responsible for providing guidance and direction to internal constituents and consulting team members as required in ...
Oversee trade contract portfolios distinctly tailored to LTC (institutional formulary, consultant pharmacy dynamics), Specialty (payer/PBM network access, hub services, LDD), and AIC (infusion suites ...
Oversee trade contract portfolios distinctly tailored to LTC (institutional formulary, consultant pharmacy dynamics), Specialty (payer/PBM network access, hub services, LDD), and AIC (infusion suites ...
Oversee trade contract portfolios distinctly tailored to LTC (institutional formulary, consultant pharmacy dynamics), Specialty (payer/PBM network access, hub services, LDD), and AIC (infusion suites ...
Oversee trade contract portfolios distinctly tailored to LTC (institutional formulary, consultant pharmacy dynamics), Specialty (payer/PBM network access, hub services, LDD), and AIC (infusion suites ...
Tampa, FL · Hybrid
Leads prospecting activities for new business and proactively calls on brokers and consultants ... PBM experience strongly preferred. * Client facing experience strongly preferred. * Ability to ...
Tampa, FL · Hybrid
Leads prospecting activities for new business and proactively calls on brokers and consultants ... PBM experience strongly preferred. * Client facing experience strongly preferred. * Ability to ...
Tampa, FL · Hybrid
Leads prospecting activities for new business and proactively calls on brokers and consultants ... PBM experience strongly preferred. * Client facing experience strongly preferred. * Ability to ...
Tampa, FL · Hybrid
Leads prospecting activities for new business and proactively calls on brokers and consultants ... PBM experience strongly preferred. * Client facing experience strongly preferred. * Ability to ...
$15.75 - $20.25/hr
Connect with one of our Professional Recruiting Consultants today to see how a conversation can ... PBM and major medical benefits, prior authorizations and appeals processing. Ability to work in a ...
$15.75 - $20.25/hr
Connect with one of our Professional Recruiting Consultants today to see how a conversation can ... PBM and major medical benefits, prior authorizations and appeals processing. Ability to work in a ...
Tallahassee, FL · On-site
$50.50 - $60.75/hr
As a Senior Specialty Consultative Pharmacist your primary responsibility will be to assess and ... Previous experience with Pharmacy Benefits Management (PBM) * Previous Commercial, Medicare, or ...
Tallahassee, FL · On-site
$50.50 - $60.75/hr
As a Senior Specialty Consultative Pharmacist your primary responsibility will be to assess and ... Previous experience with Pharmacy Benefits Management (PBM) * Previous Commercial, Medicare, or ...
Tallahassee, FL · On-site
$50.50 - $60.75/hr
As a Senior Specialty Consultative Pharmacist your primary responsibility will be to assess and ... Previous experience with Pharmacy Benefits Management (PBM) * Previous Commercial, Medicare, or ...
Tallahassee, FL · On-site
$50.50 - $60.75/hr
As a Senior Specialty Consultative Pharmacist your primary responsibility will be to assess and ... Previous experience with Pharmacy Benefits Management (PBM) * Previous Commercial, Medicare, or ...
Jacksonville, FL · On-site
$55/hr
Pharmacist (100% Remote, PBM) We are seeking a dedicated Clinical Pharmacist to join our team in a ... With a network of almost 20,000 consultants and 5,000 clients across the U.S., Canada, Asia and ...
New
Jacksonville, FL · On-site
$55/hr
Pharmacist (100% Remote, PBM) We are seeking a dedicated Clinical Pharmacist to join our team in a ... With a network of almost 20,000 consultants and 5,000 clients across the U.S., Canada, Asia and ...
New
Lauderhill, FL · On-site
$118K - $168K/yr
Assists with physician consultations, provides accurate drug information, and supports the ... Experience in managed care, HMO, PBM, or MSO settings is a plus PAY RANGE: $118,062 - $168,658 ...
Lauderhill, FL · On-site
$118K - $168K/yr
Assists with physician consultations, provides accurate drug information, and supports the ... Experience in managed care, HMO, PBM, or MSO settings is a plus PAY RANGE: $118,062 - $168,658 ...
Lakeland, FL · On-site
$18.50 - $24.25/hr
... brokers, consultants, legal personnel, trustees, etc. * Requires knowledge and use of multiple ... PBM, company specific product offerings, basic pricing components, and company capabilities and ...
Lakeland, FL · On-site
$18.50 - $24.25/hr
... brokers, consultants, legal personnel, trustees, etc. * Requires knowledge and use of multiple ... PBM, company specific product offerings, basic pricing components, and company capabilities and ...

Full-time
Re-posted 25 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.