Managed Care Finance Director jobs in Pittsburgh, PA

Managed Care Finance Director directs and oversees all policies and procedures for the financial and data operations of managed care contracts. Manages contracts, negotiates and sets rates, and reviews reimbursement levels and managed care agreements to ensure that proper payment practices are utilized. Being a Managed Care Finance Director implements processes that encourage and inform the organization how to increase levels of reimbursements. Requires a bachelor's degree. Additionally, Managed Care Finance Director typically reports to top management. The Managed Care Finance Director manages a departmental sub-function within a broader departmental function. Creates functional strategies and specific objectives for the sub-function and develops budgets/policies/procedures to support the functional infrastructure. Deep knowledge of the managed sub-function and solid knowledge of the overall departmental function. To be a Managed Care Finance Director typically requires 5+ years of managerial experience. (Copyright 2024 Salary.com)

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PBM / Managed Care Pharmacist
  • Pharmacy Careers
  • Pittsburgh, PA FULL_TIME
  • We are currently seeking a skilled and motivated Pharmacist with expertise in Pharmacy Benefit Management (PBM) and Managed Care. In this pivotal role, you will be responsible for overseeing medication utilization, formulary management, and ensuring cost-effective pharmacy services. The ideal candidate will bring a deep understanding of managed care principles, a proactive approach to problem-solving, and a commitment to optimizing pharmacy outcomes within a managed care environment.

    Preferred Qualifications:
    PharmD degree from an accredited pharmacy program
    Previous experience in Pharmacy Benefit Management (PBM) or Managed Care
    Knowledge of formulary development and management
    State pharmacy license in good standing
    Strong analytical and data interpretation skills
    Excellent communication and negotiation abilities
    Familiarity with healthcare regulations and compliance standards
    Collaboration experience with healthcare providers, payers, and pharmaceutical manufacturers
    Proficiency in utilizing pharmacy management software and tools
    Active participation in relevant professional organizations
    Dedication to staying informed about industry trends and innovations

    Responsibilities:
    Collaborate with healthcare stakeholders to implement and optimize pharmacy benefit programs
    Conduct formulary reviews and assessments to ensure cost-effective and evidence-based medication choices
    Monitor and analyze pharmacy utilization trends, identifying opportunities for cost savings and improved patient outcomes
    Provide expertise in drug utilization management and prior authorization processes
    Stay informed about industry regulations, guidelines, and emerging trends in managed care pharmacy
    If you are a passionate and experienced pharmacist with a background in PBM or Managed Care, we invite you to join our dynamic team dedicated to advancing healthcare through innovative and cost-effective pharmacy solutions. Apply now to contribute to the future of managed care pharmacy.
  • 1 Month Ago

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Director of Finance
  • University of Pittsburgh
  • Pittsburgh, PA FULL_TIME
  • Director of Finance The University of Pittsburgh School of Health and Rehabilitation Sciences (SHRS) is a nationally renowned leader in the field of health care education, research, and clinical pract...
  • 1 Day Ago

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Director Finance
  • ExpenseAnywhere
  • Monroeville, PA FULL_TIME
  • ExpenseAnywhere is a global leader in cloud-based corporate spend management automation solutions. Our highly automated, touchless advanced technology solutions help businesses automate their Accounts...
  • 8 Days Ago

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Finance Director
  • ExpenseAnywhere
  • Monroeville, PA FULL_TIME
  • ExpenseAnywhere is a global leader in cloud-based corporate spend management automation solutions. Our highly automated, touchless advanced technology solutions help businesses automate their Accounts...
  • 9 Days Ago

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Finance Director
  • Cranberry Township
  • Cranberry, PA FULL_TIME
  • Cranberry Township, Butler County, is seeking applicants for a full-time Director for the Finance Department. Cranberry Township is a growing residential and business community and as the Director of ...
  • 12 Days Ago

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Director of Finance
  • LONGUE VUE CLUB
  • Verona, PA OTHER
  • Job Details Level: Management Job Location: Main Location - Verona, PA Position Type: Full Time Education Level: 4 Year Degree Salary Range: Undisclosed Travel Percentage: None Job Shift: Day Job Cate...
  • 14 Days Ago

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0 Managed Care Finance Director jobs found in Pittsburgh, PA area

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Area President
  • FocusCFO®
  • Pittsburgh, PA
  • FocusCFO® is the largest fractional CFO services company in the Midwest and Southeast US. We are presently expanding in ...
  • 4/24/2024 12:00:00 AM

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Medical Assistant - Diagnostic Coordinator, Murrysville
  • Johnson Consulting LLC
  • Murrysville, PA
  • Job Description Job Description Jobs location is in Murrysville, PA. We are looking to hire diagnostic coordinators to p...
  • 4/24/2024 12:00:00 AM

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Medical Assistant - Diagnostic Coordinator
  • Johnson Consulting LLC
  • Washington, PA
  • Job Description Job Description Jobs location is in Washington, PA. We are looking to hire diagnostic coordinators to pe...
  • 4/24/2024 12:00:00 AM

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Vice President Finance
  • SAE International
  • Warrendale, PA
  • Job Summary Lead the development and implementation of robust financial strategies and policies across the company and s...
  • 4/23/2024 12:00:00 AM

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CFO
  • Creative Financial Staffing
  • Pittsburgh, PA
  • CHIEF FINANCIAL OFFICER (CFO)Pittsburgh, PACFS is seeking an experienced Chief Financial Officer (CFO) to join the leade...
  • 4/23/2024 12:00:00 AM

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Vice President Finance
  • Sae International
  • Warrendale, PA
  • Job Summary Lead the development and implementation of robust financial strategies and policies across the company and s...
  • 4/23/2024 12:00:00 AM

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Payroll Manager
  • Passavant Memorial Homes
  • Pittsburgh, PA
  • Passavant Memorial Homes is one of the foremost, consumer-focused providers of support to individuals with intellectual ...
  • 4/22/2024 12:00:00 AM

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Chief Financial Officer/Corporate Controller
  • CANNON USA, INC.
  • Pittsburgh, PA
  • Job Description Job Description We are searching for a CFO/Corporate Controller for a small to medium sized manufacturin...
  • 4/20/2024 12:00:00 AM

Pittsburgh (/ˈpɪtsbɜːrɡ/ PITS-burg) is a city in the Commonwealth of Pennsylvania in the United States, and is the county seat of Allegheny County. As of 2018, a population of 308,144 lives within the city limits, making it the 63rd-largest city in the U.S. The metropolitan population of 2,362,453, is the largest in both the Ohio Valley and Appalachia, the second-largest in Pennsylvania (behind Philadelphia), and the 26th-largest in the U.S. Pittsburgh is located in the south west of the state, at the confluence of the Allegheny, Monongahela, and Ohio rivers. Pittsburgh is known both as "the ...
Source: Wikipedia (as of 04/11/2019). Read more from Wikipedia
Income Estimation for Managed Care Finance Director jobs
$140,498 to $181,542
Pittsburgh, Pennsylvania area prices
were up 1.9% from a year ago

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