14 director of pharmacy services jobs found

As a   Health and Benefits Director, you will be a leader on the client service team and will be responsible for fostering relationships cross the client organization. You will be responsible for managing a wide array of projects, leveraging your experience to make recommendations on plan design and management for the full array of health and benefits programs. You will have the opportunity to generate business by participating in new business activities and expanding existing client engagements.  You will have the opportunity to position yourself to grow into a senior relationship management and/or leadership role by serving as the pivotal point of contact on all projects and working alongside industry experts on cutting edge solutions. The Role Lead the design/management of group medical, dental, wellbeing, disability and time off plans for clients. Responsibilities include: Serving as lead project manager for clients; materially contributing to project plan creation and...

Overview AmTrust Financial Services, a fast growing commercial insurance company, has a need for a Telephonic Medical Case Manager, RN.   PRIMARY PURPOSE: To provide comprehensive quality telephonic case management to proactively drive a medically appropriate return to work through engagement with the injured employee, provider and employer.  Our nurses will be empathetic informative medical resources for our injured employees and they will partner with our adjusters to develop a personalized holistic approach for each claim.  These responsibilities may include utilization review, pharmacy oversight and care coordination.    This position will be hybrid out of our Dallas, TX or Overland Park, KS office. Responsibilities Uses clinical/nursing skills to determine whether all aspects of a patient’s care, at every level, are medically necessary and appropriately delivered. Perform Utilization Review activities...

The CERIS Implementation Director is responsible for providing strategic leadership and oversight for the implementation of new and existing client programs, product enhancements, and service expansions. This role ensures the successful execution of complex implementations while aligning implementation strategy with organizational objectives, operational readiness, and long‑term client success. The CERIS Implementation Director works closely with executive leadership, Account Management, Implementation Managers and Coordinators, IT, Operations, Product, and Sales to ensure consistent, high‑quality delivery and a seamless transition to ongoing account management and field operations. This role is also accountable for leading and developing the Implementation team and continuously improving implementation processes across the organization. This is a remote position. ESSENTIAL FUNCTIONS & RESPONSIBILITIES: Provides overall leadership and accountability for the...

As a Health and Benefits Manager, you will be a key member of the client service team, engaging directly with clients and establishing relationships across all levels of the client organization. You will substantially contribute to the management of projects, leveraging your experience as a benefits expert to make recommendations on plan design and management for the full array of health and benefits programs. You will have the opportunity to position yourself to grow into a senior relationship management and/or leadership role by serving as a pivotal point of contact on projects and working alongside industry experts on cutting edge solutions. The Role: Play a lead role in the design and management of group medical, dental, wellbeing, life, disability and absence management benefits for clients. Responsibilities include:  Materially contributing to and/or leading project management; monitoring progress against established objectives, budgets, timelines, deliverables and...

To perform this job successfully, an individual must be able to perform each essential duty satisfactorily. The requirements listed below are representative of the knowledge, skill, and/or ability required. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions. ESSENTIAL DUTIES AND RESPONSIBLITIES: • Project client claim data to develop budgets, calculate client rates, benefit costs, and IBNR reserves • Review experience reporting for accuracy • Collaborate with consultants and account teams to prepare and deliver client financial presentations • Assess complex client risk, understanding the strategic implications of the competitive carrier/product marketplace, and make sound underwriting-based assumptions • Manage and oversight of underwriting support team • Renew and market carriers for assigned book of business • Analyze / negotiate annual renewals and proposals from carriers for accuracy and financial...

To perform this job successfully, an individual must be able to perform each essential duty satisfactorily. The requirements listed below are representative of the knowledge, skill, and/or ability required. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions. ESSENTIAL DUTIES AND RESPONSIBLITIES: • Project client claim data to develop budgets, calculate client rates, benefit costs, and IBNR reserves • Review experience reporting for accuracy • Collaborate with consultants and account teams to prepare and deliver client financial presentations • Assess complex client risk, understanding the strategic implications of the competitive carrier/product marketplace, and make sound underwriting-based assumptions • Manage and oversight of underwriting support team • Renew and market carriers for assigned book of business • Analyze / negotiate annual renewals and proposals from carriers for accuracy and financial...

To perform this job successfully, an individual must be able to perform each essential duty satisfactorily. The requirements listed below are representative of the knowledge, skill, and/or ability required. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions. ESSENTIAL DUTIES AND RESPONSIBLITIES: • Project client claim data to develop budgets, calculate client rates, benefit costs, and IBNR reserves • Review experience reporting for accuracy • Collaborate with consultants and account teams to prepare and deliver client financial presentations • Assess complex client risk, understanding the strategic implications of the competitive carrier/product marketplace, and make sound underwriting-based assumptions • Manage and oversight of underwriting support team • Renew and market carriers for assigned book of business • Analyze / negotiate annual renewals and proposals from carriers for accuracy and financial...

Summary of Role     Health & Benefits North America (H&BNA) is seeking a MidMarket Specialties Leader to play a pivotal role in driving the strategy, growth, and delivery of specialty capabilities across the MidMarket segment.   The MidMarket (MM) Specialties Leader is a key member of the Health & Benefits Strategy & Specialty leadership team with accountability for the strategy, growth, talent, and delivery of specialty capabilities serving the MidMarket segment. In this role, you will have primary responsibility for holistically advancing performance of the specialty teams (Compliance Audit & MHPAEA, Group Benefits, Health, Equity & Wellbeing, Pharmacy) through revenue growth, talent development, intellectual capital, and consistent, high quality client delivery for the MidMarket.  The MM Specialties Leader is responsible for shaping and executing the mid-market specialty strategy in support of business objectives and in collaboration with...

As one of the leading writers of Federal Crop Insurance, AgriSompo North America combines industry experience, resources, capital and talent to deliver both traditional and innovative crop insurance and productivity tools to farmers, ranchers, insurers and agribusinesses in the United States. Our organization operates within a culture rooted in ethics, integrity and a belief that accountability, collaboration and agility are crucial to long-term success.  AgriSompo North America is a part of AgriSompo, Sompo International’s global agriculture platform. This platform is an integrated underwriting, technology and distribution platform delivering innovate insurance and reinsurance solutions to agriculture partners worldwide.  Sompo International, AgriSompo’s parent company, is a global organization driven by its core values, a carrier that holds promise, trust and the commitment to protect.  Through operating subsidiaries, Sompo International writes agriculture, casualty and...

Built on meritocracy, our unique company culture rewards self-starters and those who are committed to doing what is best for our customers. Brown & Brown is seeking a Technical Project Manager to join our growing team! The Technical Project Manager will lead the planning, execution, and delivery of enterprise software development platform initiatives across the organization. This role demands hands-on technical project leadership with a strong foundation in PMI methodologies, project financial management, and cross-functional coordination spanning multiple business verticals. The individual will partner with business leaders, development teams, analysts, and external vendors to deliver complex technology projects on time, within budget, and within scope—while maintaining clear, consistent communication with senior leadership. A working background in Employee Benefits is required, with particular value placed on experience supporting pharmacy management operations...

Job Description Are you looking for your next opportunity? Sompo has a unique opportunity for a Vice President, South-Central Regional Underwriting Manager as part of our Commercial Management Liability team. Our Sompo Commercial Management Liability team offers diverse capabilities targeted at providing Directors & Officers, Employment Practices, Fiduciary, and Commercial Crime Liability coverages for publicly-traded and privately-held companies, as well as not-for-profit organizations. We work through a network of Retail & Wholesale brokers who share our commitment to long-term partnerships built on a strong service proposition. Location: This position will be based out of our Dallas or Houston, TX office. We strive for collaboration which is why we offer a work environment where our employees thrive and develop long lasting careers. Our business, your impact, our opportunity: What you will be doing: • Direct management responsibilities...

The Payment Integrity Supervisor is responsible for the daily activities of payment integrity team related to quality assurance and provider appeals. The Supervisor manages and prioritizes staff daily work assignments necessary to ensure the timely and accurate processing of internal and external requests, interdepartmental quality audits and appeals. Additionally, the supervisor works to reduce response timeframes and mitigate future inquiries or escalations by being proactive, taking ownership of challenges, and formulating solutions to improve overall department activities while maintaining a focus on improving how we deliver service to our customers.  This is a remote position. ESSENTIAL FUNCTIONS AND RESPONSIBILITIES: Supervises all daily activities of payment integrity team related to quality assurance and provider appeals Ability to assist team with problem-solving, payer policy and clinical questions regarding audits performed by CERIS Ability to...

The Claims Supervisor is responsible for supervising a team of direct reports, ensuring all quality, productivity and customer service criteria are met while adhering to company policies and procedures. The Claims Supervisor position is integral to the success of the company and requires regular and consistent attendance, supporting the goals of the claims department and CorVel. This is a hybrid position. ESSENTIAL FUNCTIONS & RESPONSIBILITIES: Supervises claims staff in their day-to-day operations Assists Claims Manager with recruitment, interviewing, and onboarding new staff, ensuring proficiency in procedures and job functions Ensures staff compliance with Workers’ Compensation laws and mandated regulatory reporting requirements Ensures optimal team performance through ongoing training, coaching, and regular performance evaluations; recommends merit-based actions (subject to managerial approval) Provides technical and jurisdictional guidance to claims staff...

The hospital bill audit nurse supervisor will maintain a positive team building approach with emphasis on overseeing the day to day functions of hospital bill audit nurses, reporting, leadership and professional communication with all CERiS departments.  This is a remote position. ESSENTIAL FUNCTIONS & RESPONSIBILITIES: Utilize nursing education, experience and industry best practices to lead a team of registered nurses to plan, execute and deliver timely and accurate hospital bill audits Ensure accuracy of audits through acquired knowledge of client policies, provider contract information, and other standard guidelines Assist in the development and support of auditors to meet and exceed productivity requirements based on CERiS productivity standards Act as a point of contact to answer and resolve auditor issues with the goal of providing excellent customer service and relationship management  Perform audits as necessary Keep manager informed of any issues...