Pharmacy Benefits Management (PBM) SME

Hi, Looking for a PBM SME with strong experience in pharmacy claims, formulary, pricing, and end-to-end PBM operations. Core PBM Skills: Pharmacy Benefit Management (PBM) domain expertiseClaims processing (Pharmacy claims lifecycle)Formulary managementPrior Authorization (PA)Rebate managementDrug pricing (AWP, MAC, WAC)Eligibility & benefits configurationFunctional / Business Skills: Requirements gathering & analysisStakeholder communicationUAT support & business validationProcess improvementTe

Job Title:- Professional Billing (PB) Analyst Job Location:- Fully remote after Day 1. Long Term Contract Overview Client is seeking a Professional Billing (PB) Analyst with strong PB operational and/or PB build experience to support our Revenue Cycle team during a period of transition. This role is primarily focused on run and maintain support, ad hoc tasks, and ticket resolution while the core team shifts to an upcoming Refuel initiative. Key Responsibilities Operational Support & Mainten

Great companies need great teams to propel their operations. Join the group that solves business challenges and enhances the way we work and grow. Working at Gainwell carries its rewards. You'll have an incredible opportunity to grow your career in a company that values your contributions and puts a premium on work flexibility, learning, and career development. Summary As an Advisor Business Analyst - Pharmacy at Gainwell, you will help drive Pharmacy technology solutions to improve health outc

Sr BPM(Camunda) Developer- Dallas, TX (Onsite) Fulltime with Photon The Principal BPM Camunda, engineer is expected to closely collaborate with business, product and service line teams to create these automated processes. Technical Skills we are looking for during the interview The ideal candidate has the following skills in priority order. Skills listed as very helpful or helpful are not strictly required. 5 years+ of BPM experience (2 years+ of Camunda experience) Experience calling Camu