Pharmacy Benefit Management Examiner
Examination Resources, LLC$95K – $140K per yearUnited States only
Apply now
Opens the original posting on Himalayas.
Apply nowSource: HimalayasApply on the original site
Companies in this catalog do not charge applicants. Never send money to apply.
Position Overview
The Senior Examiner of Pharmacy Benefit Manager (PBM) Compliance Services will act as a PBM Specialist and/or Examiner in Charge on PBM compliance audits on behalf of state regulators, in accordance with state rules and regulations, established procedures, industry standards and best practices.
Specific Duties and Responsibilities
Lead PBM audit examinations across various states and PBM entities in accordance with state requirements, including, but not limited to, review of pharmacy audits conducted by PBMs, pharmacy reimbursement, health plan and pharmacy contract review, analyze MFG revenue (Rx Rebates, etc.), MAC appeals, claims processing, and network adequacy, etc.