... payer/TPA/PBM benefits. * Expertise in using SQL to join complex datasets, investigate ... Paid Time Off (vacation, sick leave. parental leave, and holidays). * 100% remote work. * The ...
New
... payer/TPA/PBM benefits. * Expertise in using SQL to join complex datasets, investigate ... Paid Time Off (vacation, sick leave. parental leave, and holidays). * 100% remote work. * The ...
New
Remote Pbm information
What is a remote PBM?
Remote PBMs, or Remote Pharmacy Benefit Managers, are professionals who manage prescription drug benefits for health plans, employers, and other groups from a remote location. They are responsible for ensuring that members receive appropriate, cost-effective medications while balancing the needs of both patients and payers. Remote PBMs work with pharmacies, insurance companies, and healthcare providers to process claims, negotiate pricing, and implement drug formulary policies. This role can be performed from home or other off-site locations using secure digital tools and platforms.
What are the key skills and qualifications needed to thrive as a remote Pharmacy Benefit Manager (PBM), and why are they important?
To thrive as a Remote Pharmacy Benefit Manager (PBM), you need a strong background in pharmacy, healthcare administration, or a related field, often supported by relevant degrees or certifications. Familiarity with pharmacy benefit management software, claims processing systems, and data analytics tools is typically required. Exceptional attention to detail, analytical thinking, and effective communication are crucial soft skills for collaborating with stakeholders and resolving complex issues remotely. These skills ensure accurate benefit administration, regulatory compliance, and positive outcomes for clients and patients in a remote work environment.
What are some common challenges faced by remote PBM professionals, and how can they be addressed?
Remote PBM professionals often encounter challenges such as maintaining effective communication with team members, staying updated on regulatory changes, and managing sensitive health information securely. To address these, it's important to leverage collaboration tools, participate in regular virtual meetings, and stay engaged with ongoing training. Additionally, adhering to best practices for data privacy and fostering strong relationships with both clients and pharmacies can help ensure smooth operations and job satisfaction.
What is the difference between Remote Pbm vs Remote Pharmacovigilance Associate?
| Aspect | Remote Pbm | Remote Pharmacovigilance Associate |
|---|---|---|
| Required Credentials | Pharmacy or healthcare background, certifications like CPR or pharmacy license | Healthcare degree, certifications in pharmacovigilance or drug safety |
| Work Environment | Remote, healthcare or pharmacy settings | Remote, pharmaceutical or biotech companies |
| Industry Usage | Pharmacy, healthcare providers, clinical settings | Pharmaceutical industry, drug safety departments |
| Common Search/Comparison | Remote Pbm vs Remote Pharmacovigilance Associate |
Remote Pbm roles focus on pharmacy benefit management, involving healthcare and insurance processes, while Remote Pharmacovigilance Associate positions are centered on drug safety and monitoring adverse effects in the pharmaceutical industry. Both roles are remote, require healthcare-related credentials, and are used within healthcare and pharma sectors, but they serve different functions within the industry.
More about Remote Pbm jobs
Healthcare Data and Analytics Specialist - Remote - USA
Frankfort, KY • On-site, Remote
Full-time
Medical, Dental, Vision, Retirement, PTO
Posted yesterday
New
Job description
About FullStack
FullStack is one of the fastest-growing software consultancy companies in the Americas. We deliver transformational digital solutions to top global companies and Silicon Valley startups. As an employee-first company, we focus on hiring the most talented software designers and developers by creating a positive, respectful, and supportive work environment where they can achieve their greatest potential.
We're most proud of:
The Position
We're looking to hire a Healthcare Data and Analytics Specialist to join our team. You'll work with our incredible clients in one of two ways:
What We Are Looking For
What We Offer
FullStack is proud to be an equal opportunity workplace. We are committed to equal employment opportunity regardless of race, color, ancestry, religion, sex, national origin, sexual orientation, age, citizenship, marital status, disability, gender identity, or Veteran status.
Learn more about our Applicants Privacy Notice .
FullStack is one of the fastest-growing software consultancy companies in the Americas. We deliver transformational digital solutions to top global companies and Silicon Valley startups. As an employee-first company, we focus on hiring the most talented software designers and developers by creating a positive, respectful, and supportive work environment where they can achieve their greatest potential.
We're most proud of:
- Offering life-changing career opportunities to talented software professionals across the Americas.
- Building highly-skilled software development teams for hundreds of the world's greatest companies.
- Having delivered hundreds of successful custom software solutions, which have positively impacted the lives and careers of millions of users.
- Our 4.2-star rating on GlassDoor.
- Our client Net Promoter Score of 68, twice the industry average.
The Position
We're looking to hire a Healthcare Data and Analytics Specialist to join our team. You'll work with our incredible clients in one of two ways:
- Team Augmentation: You will integrate directly into our client's team and work alongside their existing designers and engineers daily.
- Design & Build: You will work on a FullStack product team to build and deliver a product to our clients.
What We Are Looking For
- 5+ years of professional software engineering, data analysis, or data operations experience.
- Advanced English is required.
- Successful completion of a four-year college degree is required.
- Deep experience in working with healthcare data, including medical claims, pharmacy claims, eligibility, enrollment, or payer/TPA/PBM benefits.
- Expertise in using SQL to join complex datasets, investigate discrepancies, and construct maintainable analytical logic.
- Solid background in healthcare data validation, reconciliation, data quality monitoring, and data operations workflows.
- Solid understanding of healthcare claims structures, terminology, utilization, and financial metrics (such as allowed and paid amounts).
- Track record of creating recurring analytical reporting, data dictionaries, and metric definitions for clients, employers, or executives.
- Demonstrated experience investigating data issues and tracing discrepancies through different stages of a data ecosystem.
- Comfortable working with relational databases (such as PostgreSQL) and familiar with file transmissions like SFTP, flat files, or APIs.
- Knowledgeable in HIPAA compliance, protected health information (PHI) regulations, and healthcare data security controls.
- Ability to work through new and difficult issues and contribute to libraries as needed.
- Ability to create and maintain continuous integration and delivery of applications.
- Forensic attention to detail.
- A positive mindset and a can-do attitude.
- Experience working on Agile/Scrum teams.
- Meaningful experience working on large, complex systems.
- Ability to take extreme ownership over your work. Every day is a challenge to ensure you are performing to the expectations you and your team have agreed upon.
- Ability to identify with the goals of FullStack's clients and dedicate yourself to delivering on the commitments you and your team make to them.
What We Offer
- Competitive Salary.
- Paid Time Off (vacation, sick leave. parental leave, and holidays).
- 100% remote work.
- The ability to work with leading startups and Fortune 500 companies.
- Health, dental, and vision insurance.
- 401(k) w/ 4% match.
- Ample opportunity for career advancement.
- Continuing education opportunities.
FullStack is proud to be an equal opportunity workplace. We are committed to equal employment opportunity regardless of race, color, ancestry, religion, sex, national origin, sexual orientation, age, citizenship, marital status, disability, gender identity, or Veteran status.
Learn more about our Applicants Privacy Notice .
About FullStack Labs
Sourced by ZipRecruiter
FullStack Labs is the fastest-growing software consultancy in the Americas. We help organizations like Uber, GoDaddy, MGM, Siemens, Stanford University, and the State of California, build distributed software development teams, and deliver transformational digital solutions. As an employee-first company, we focus on hiring the most talented software designers and developers in the western hemisphere, by creating a positive, respectful, and supportive work environment where they can achieve their greatest potential.
Industry
It services
Company size
11 - 50 Employees
Headquarters location
Sacramento, CA, US
Year founded
2013