PR · On-site
$14.25 - $17.50/hr
... in accessing treatment, managing authorizations, coordinating with healthcare providers, and ... This role requires strong knowledge of pharmacy benefit processes, attention to detail, and full ...
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PR · On-site
$14.25 - $17.50/hr
... in accessing treatment, managing authorizations, coordinating with healthcare providers, and ... This role requires strong knowledge of pharmacy benefit processes, attention to detail, and full ...
Director(a) De Formularios Y Medicamentos Especializados
San Juan, PR · On-site
$110 - $140/hr
Participate in the drug rebates meetings with the Pharmacy Benefits Management (PBM). Identifies and request new rebate negotiation opportunities. Evaluate drug rebate scenarios and recommend ...
Director(a) De Formularios Y Medicamentos Especializados
San Juan, PR · On-site
$110 - $140/hr
Participate in the drug rebates meetings with the Pharmacy Benefits Management (PBM). Identifies and request new rebate negotiation opportunities. Evaluate drug rebate scenarios and recommend ...
Bilingual Pharmacy Technician- San Juan, PR
$17.25 - $20.75/hr
Optum Puerto Rico Operations is creating an innovative approach to Pharmacy Benefit Management. As a Pharmacy Technician - Prior Authorization, you will be answering incoming calls, completing ...
Bilingual Pharmacy Technician- San Juan, PR
$17.25 - $20.75/hr
Optum Puerto Rico Operations is creating an innovative approach to Pharmacy Benefit Management. As a Pharmacy Technician - Prior Authorization, you will be answering incoming calls, completing ...
PR · On-site
Guaynabo, PR PBM Claims Analyst is responsible for auditing, analyzing, and tracking accounts receivable related to Pharmacy Benefit Managers (PBMs) at a specialty pharmacy. This role focuses ...
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PR · On-site
Guaynabo, PR PBM Claims Analyst is responsible for auditing, analyzing, and tracking accounts receivable related to Pharmacy Benefit Managers (PBMs) at a specialty pharmacy. This role focuses ...
Pharmacy Technician
$17.25 - $20.75/hr
Job Summary The Pharmacy Call Center Representative manages telephone calls and Prior Authorizations from pharmacies and providers related to pharmacy benefits, authorization requests, and drug use ...
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Pharmacy Technician
$17.25 - $20.75/hr
Job Summary The Pharmacy Call Center Representative manages telephone calls and Prior Authorizations from pharmacies and providers related to pharmacy benefits, authorization requests, and drug use ...
PR · On-site
$16.75 - $20.25/hr
The Health Professional 1-Pharmacy Call Center Representative manages telephone calls from pharmacies and providers related to pharmacy benefits, authorization requests, drug use review, among others ...
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PR · On-site
$16.75 - $20.25/hr
The Health Professional 1-Pharmacy Call Center Representative manages telephone calls from pharmacies and providers related to pharmacy benefits, authorization requests, drug use review, among others ...
PR · On-site
Accurately analyze and interpret common Pharmacy Benefit terminology. * Manage multiple priorities ... and work independently in a fast-paced environment. * Proficiency in Microsoft Office. * Possess a ...
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PR · On-site
Guaynabo, PR El Analista de Auditoría PBM es responsable de auditar, analizar y dar seguimiento a las cuentas por cobrar relacionadas con Pharmacy Benefit Managers (PBM) en una farmacia ...
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PR · On-site
Guaynabo, PR El Analista de Auditoría PBM es responsable de auditar, analizar y dar seguimiento a las cuentas por cobrar relacionadas con Pharmacy Benefit Managers (PBM) en una farmacia ...
Pharmacist Call Center - San Juan, PR
$57 - $68.75/hr
Extended hours and occasional weekends may be required as needed Preferred Qualifications: * 1 years of Pharmacy work experience in retail, community pharmacy, or Pharmacy Benefit Management * Call ...
Pharmacist Call Center - San Juan, PR
$57 - $68.75/hr
Extended hours and occasional weekends may be required as needed Preferred Qualifications: * 1 years of Pharmacy work experience in retail, community pharmacy, or Pharmacy Benefit Management * Call ...
PR · On-site
Leads training, coaching, and performance management of pharmacy technicians. Makes decisions ... benefits
PR · On-site
Leads training, coaching, and performance management of pharmacy technicians. Makes decisions ... benefits
PR · On-site
Leads training, coaching, and performance management of pharmacy technicians. Makes decisions ... benefits
PR · On-site
Leads training, coaching, and performance management of pharmacy technicians. Makes decisions ... benefits
Leads training, coaching, and performance management of pharmacy technicians. Makes decisions regarding performance management including discipline and termination. Customer Experience * Engages ...
Leads training, coaching, and performance management of pharmacy technicians. Makes decisions regarding performance management including discipline and termination. Customer Experience * Engages ...
Pharmacy Operations Manager
Carolina, PR · On-site
Leads training, coaching, and performance management of pharmacy technicians. Makes decisions regarding performance management including discipline and termination. Customer Experience * Engages ...
Pharmacy Operations Manager
Carolina, PR · On-site
Leads training, coaching, and performance management of pharmacy technicians. Makes decisions regarding performance management including discipline and termination. Customer Experience * Engages ...
Pharmacy Operations Manager
Carolina, PR · On-site
Leads training, coaching, and performance management of pharmacy technicians. Makes decisions ... benefits
Pharmacy Operations Manager
Carolina, PR · On-site
Leads training, coaching, and performance management of pharmacy technicians. Makes decisions ... benefits
PR · On-site
Accurately analyze and interpret common Pharmacy Benefit terminology. * Manage multiple priorities and work independently in a fast-paced environment. * Proficiency in Microsoft Office. * Possess a ...
Quick apply
Here, you will find a culture guided by inclusion, talented peers, comprehensive benefits and ... Required Qualifications: * 1 years of experience in an office environment managing time-sensitive ...
Here, you will find a culture guided by inclusion, talented peers, comprehensive benefits and ... Required Qualifications: * 1 years of experience in an office environment managing time-sensitive ...
PR · On-site
$14.25 - $17.50/hr
The Pharmacy Technician - ASP is a professional in charge of receiving and processing medical ... and benefits. * Assist in managing inventory, purchasing, cleaning, and tidiness of the ...
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PR · On-site
$14.25 - $17.50/hr
The Pharmacy Technician - ASP is a professional in charge of receiving and processing medical ... and benefits. * Assist in managing inventory, purchasing, cleaning, and tidiness of the ...
Software Automation Engineer
San Juan, PR · On-site +1
Software Engineering manages the development of our suite of tech products to ensure all pharmacy benefit management services are up to date and bringing the best quality of service our clients need.
Software Automation Engineer
San Juan, PR · On-site +1
Software Engineering manages the development of our suite of tech products to ensure all pharmacy benefit management services are up to date and bringing the best quality of service our clients need.
Pharmacy Benefit Manager information
What are the key skills and qualifications needed to thrive as a pharmacy benefit manager?
To excel as a Pharmacy Benefit Manager (PBM), you need a robust understanding of pharmacy operations, healthcare regulations, and pharmacy benefit plan design, typically supported by a degree in pharmacy, healthcare administration, or a related field. Familiarity with pharmacy claims adjudication systems, data analytics tools, and compliance software is commonly required. Strong negotiation, analytical thinking, and relationship management skills help PBMs navigate partnerships with pharmacies, insurers, and clients. These competencies ensure cost-effective, compliant, and efficient management of prescription drug benefits for diverse populations.
What are some common challenges faced by pharmacy benefit managers when negotiating with pharmaceutical manufacturers and pharmacies?
Pharmacy Benefit Managers (PBMs) often navigate complex negotiations with both pharmaceutical manufacturers and pharmacy networks to secure favorable pricing and formulary placement. A key challenge is balancing cost savings for clients while ensuring access to necessary medications for members. PBMs must also stay updated on regulatory changes and manage potential conflicts of interest, all while maintaining transparent relationships with stakeholders. Successfully addressing these challenges requires strong analytical, negotiation, and communication skills, as well as a deep understanding of the pharmaceutical landscape.
What is the difference between Pharmacy Benefit Manager vs Pharmacist?
| Aspect | Pharmacy Benefit Manager | Pharmacist |
|---|---|---|
| Credentials | Typically requires a bachelor's degree in health administration, pharmacy, or related field; certifications vary | Requires a Doctor of Pharmacy (Pharm.D.) degree and licensure |
| Work Environment | Corporate offices, insurance companies, healthcare plans | Community pharmacies, hospitals, clinics |
| Industry Usage | Health insurance, pharmacy benefit management companies | Retail pharmacy, hospital pharmacy |
| Primary Focus | Managing prescription drug benefits, formulary management, cost control | Dispensing medications, patient counseling, medication management |
While Pharmacy Benefit Managers focus on managing prescription benefits and controlling costs for insurance providers, pharmacists are healthcare professionals who dispense medications and provide patient care. Both roles are essential in the pharmacy industry but serve different functions within the healthcare system.
What does a pharmacy benefit manager do?
A pharmacy benefit manager (PBM) is a healthcare professional or company that administers prescription drug plans for health insurers, employers, and government programs. They negotiate with drug manufacturers, develop formularies, process claims, and work to control drug costs and improve medication access. PBMs often use data analysis and industry knowledge to optimize pharmacy benefits and ensure efficient medication management.
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$14.25 - $17.50/hr
Full-time
Re-posted 26 days ago
Job description
Are you passionate about delivering high-quality care and patient guidance? This might be your next role at Alivia Specialty Pharmacy!
Role Summary:
We’re seeking a dedicated professional to support neurology patients in accessing treatment, managing authorizations, coordinating with healthcare providers, and providing ongoing case support. This role requires strong knowledge of pharmacy benefit processes, attention to detail, and full compliance with applicable healthcare regulations.
Key Requirements:
Associate degree and active Pharmacy Technician license.
Customer service and case management experience.
Bilingual: English & Spanish proficiency (verbal and written).
Familiarity with medical/pharmacy benefit processes.
If interested, please contact Human Resources or submit your application.
EEOC F/M/D/V