Our work matters. We help people get the medicine they need to feel better and live well. We do not lose sight of that. It fuels our passion and drives every decision we make.
Job Posting Title
340B Onsite Pharmacy Auditor – Remote in the Florida market
Job Description
The Onsite Pharmacy Auditor travels to pharmacy locations and performs pharmacy audits and is responsible for the selection and auditing of claims, educating Prime’s network pharmacies and driving contract compliance, and supporting downstream claim corrections to eliminate potential waste.
Responsibilities
Evaluate potential pharmacies to include in onsite trips considering such information as claim analytic data, prior audit history, and/or referrals, and submit recommended audit plan to manager for approval; finalize onsite audit plans and schedule trips in accordance to Prime’s travel and expense policy
Analyze pharmacy claims to identify those at the highest risk for error; leverage audit analytics and professional knowledge to identify educational trends and select claims for audit in alignment to department procedures and objectives
Leverage professional pharmacy technician knowledge to validate claim documentation and systems data while onsite to ensure claim was accurately processed in accordance with contractual and regulatory obligations. Educate external pharmacy staff on results of observations of pharmacy practices, proper claim submission and the use of Prime Therapeutics’ Pharmacy Provider Manual at all stages of the audit process
Assist in the development and enhancement of audit tools and processes to effectively identify erroneous claims, non-compliant pharmacy practices or potential pharmacy reimbursements
Track audit activities to support data analysis and reporting efforts within the department Prepare initial audit reports to be sent to the network pharmacies
Other duties as assigned
Minimum Qualifications
Bachelor’s degree in Health Science or equivalent combination of education and related work experience; HS diploma or GED is required
National Pharmacy Technician Certification through PTCB or ExCPT (CPhT)
2 years of work experience in retail, long term care, specialty, home infusion, or mail order pharmacy or combined pharmacy and PBM experience to include:
2 years of work experience in audit or quality assurance
1 year of work experience in customer service or a client facing role
Must be eligible to work in the United States without need for work visa or residency sponsorship
Additional Qualifications
Proficiency in MS Word, Excel, and database software
Intermediate skill and understanding of the point of sale and on-line pharmacy claims processing environment
Excellent oral, written and interpersonal communication skills
Self-directed worker with excellent organization and analytical skills
Ability to work effectively with a variety of audiences at all levels of the organization
Ability to maintain confidentiality of highly sensitive information
Professional appearance, demeanor, and conflict resolution skills
Current Registration with State Board of Pharmacy in the state where position is located
Previous PBM experience
Minimum Physical Job Requirements
Ability to travel up to 50% of the time
Ability to work a flexible schedule including weekends, holidays, or shifts outside of Prime’s core business hours of 9:00am-4:00pm
Frequently required to sit, use hands to handle or feel, talk and hear
Frequently required to stand, use hands to handle or feel, talk and hear
Frequently required to reach with hands and arms
Occasionally required to stand, walk and stoop, kneel, and crouch
Occasionally required to lift and/or move up to 10 pounds and occasionally lift and/or move up to 25 pounds
Specific vision abilities required by this job include close vision, distance vision, color vision, peripheral vision, depth perception and ability to adjust focus
Reporting Structure
Reports to a Manager in the Pharmacy Audit and FWA department
Potential pay for this position ranges from $57,600.00 – $86,800.00 based on experience and skills. Pay range may vary by 8% depending on applicant location.
The Technical Program Manager will manage the execution of cross-functional work. They will ensure projects are completed on time and within budget. This individual will assess risks, communicate progress and challenges to key stakeholders, and manage the overall health of the programs they oversee to ensure successful outcomes. Success in this role requires strong communication and organizational skills to drive complex projects to fruition.
We are All Leaders at Carhartt
In our words and by our actions, we strive to emulate the hardworking example set forth by our founder, Hamilton Carhartt. We Lead Business by creating value, delivering on results, and making changes along the way. We Lead Self by being inclusive, recognizing that our differences make us stronger as we strive to build a better world, together, for all hardworking people. We Lead Others by communicating and clearly defining the path as we walk bravely into the future. Working at Carhartt, we are all given a seat at the table and the honor of continuing the legacy.
Responsibilities
Accountable to defining project scope, objectives, and deliverables in collaboration with stakeholders, ensuring a clear understanding of project goals.
Creates detailed implementation plans that encompass timelines, milestones, resource allocation, and dependencies.
Participates in quarterly planning sessions to contribute to the prioritization and progress monitoring of projects.
Manages risks and issues that have the potential to impact project success, using risk mitigation strategies and contingency planning.
Oversees and coordinates dependencies between various project components.
Provides regular status updates and reports to sponsors and project stakeholders.
Manages project expenses to ensure budget is maintained.
Defines and tracks the expected benefits and outcomes, ensuring that the project delivers on its strategic promises.
Works closely with the IT Portfolio Lead to ensure adoption of standard processes and templates.
Executes closure activities, including post-implementation review and documentation.
Education
Bachelor’s Degree Required
Equivalent work experience may be considered in lieu of degree
Required Skills and Experience
Minimum of 8 years of relevant work experience in a related role inclusive of:
5 years of program or project management experience
Project management skills with the ability to manage scopes, timelines and budgets
Experience with Supply Chain, Manufacturing Technology
Familiarity with relevant domain, technology and tools
Experience in Agile methodology
Excellent written and verbal communication skills with the ability to communicate with stakeholders at all levels of the organization
Ability to think strategically and align program goals with the overall strategic objectives of Carhartt
Outstanding organizational skills with demonstrated ability to prioritize workload and attention to detail
Familiarity with relevant domain, technology and tools
Apparel, Retail or Consumer Products manufacturing experience preferred
Working Conditions
Office Environment
Ability to sit and/or stand for extended periods of time
Willing to work some weekends if necessary
Remote location: Associate will have no regular requirement to be on-site. Travel on-site is limited to special events.
Tobacco Free
#LI-Remote
Nearest Major Market: Dearborn Nearest Secondary Market: Detroit
Grounded by a history that is deeply rooted in innovation, Hexion is a global employer committed to building and protecting the future by producing innovative performance materials. Our materials are the building blocks for critical industries, including construction, agriculture, energy, automotive, and infrastructure protection. Everywhere you look, you will find our materials and people at work to help customers make products that are stronger, safer, and cleaner. When you work for Hexion, you’ll join a team that is committed to operating safely and with integrity to build a more sustainable future for all, our associates, our customers, and the communities where we live and work.
Position Overview
The Performance Adhesives business of Hexion, Inc. is currently looking for a Technical Service Representative based in the Eastern US. The position will support the upper Midwest and East Coast regions. This position is primarily responsible for providing technical support to our customers for a variety of application areas in both structural and non-structural product lines. The position provides technical applications expertise to strengthen market position and increase customer value.
The position also drives market development and new customer acquisition.
Please note: This is a remote – Mid West position and can be based out of: MI, WI, MN, OH, NC, SC, MO, AR.
Job Responsibilities
Drive innovation of technology and market development related to Performance Adhesive applications.
Identify potential sales, service, and other growth opportunities.
Plan, coordinate and assist with projects/product trials at customer sites.
Work individually and as a team to meet customer requirements, needs and expectations.
Integrate technology knowledge with customer process understanding to develop strategies for improving Hexion products.
Effective communication with customers, R&D, Supply Chain and Manufacturing.
Develop knowledge of Hexion product line and chemistry.
Minimum Qualifications
Minimum Education
College degree in Chemistry or Wood Science or Materials Science preferred, but relevant experience will also be considered.
Minimum Experience
A minimum of five years commercial support and technical service experience in the wood/forest products or chemical industry. Other applicable industry experience may be considered.
Minimum Qualifications
A minimum of 5 years commercial technical service experience is preferred. Other applicable industry experience may be considered.
Excellent communication skills (written and oral) and the ability to communicate effectively with individuals at all levels within Hexion and at customer locations.
Highly organized and self- directed.
Strong computer skills with experience with Microsoft Office, Minitab and SAP is desired
Background or experience with design of experiment (DOE’s). Experience with stage processes is desired.
Physical Requirements of the job
Must have a valid driver’s license
Ability to travel (by car and air travel) up to 50% as needed
Ability to work safely in Hexion laboratory and plant, as well as similar customer environments.
Other
We are an Equal Opportunity, Affirmative Action employer. All qualified applicants will receive consideration for employment without regard to gender, minority status, sexual orientation, gender identity, protected veteran status, status as a qualified individual with a disability or any characteristic protected by law.
In order to be considered for this position candidates are required to submit an application for employment through our career site, be at least 18 years of age, willing to take a drug test, submit to a background investigation as part of the selection process, as well as additional periodic background checks as required by the Chemical Facility Anti-Terrorism Standards (CFATS) or regulations adopted by the department of Homeland Security or other regulatory agencies.
Candidates are required to have unrestricted authorization to work in the United States.
If currently an employee of the Company, you must have current satisfactory work performance and in most cases, have been in your current role for 18 months.
Disclaimer: We are not accepting unsolicited assistance from search firms/employment agencies for this employment opportunity. Please, no phone calls or emails to any employee about this position. All resumes submitted by search firms/employment agencies to any employee of the Company via email, the Internet, or in any other form and/or method without a valid written search firm agreement in place for this position will be deemed the sole property of the Company; no fee will be paid in the event a candidate is hired by the Company as a result of the unsolicited referral or through other means.
The Principal Engineer will play a pivotal role in designing, architecting, and scaling CVS Health’s core compute platforms. You will be responsible for the engineering of server hardware, operating systems, automation, and integration of both on-premises and cloud-based solutions. Your expertise will shape our ability to deploy highly available, performant, and secure compute environments that support critical healthcare operations.
Responsibilities
Architecture and Design: Design and implement robust, scalable, and cost-effective compute infrastructure solutions to meet the evolving needs of CVS Health. Collaborate with other infrastructure teams to ensure smooth integration of compute platforms.
Hardware Engineering: Architect and optimize server hardware configurations, drive the hardware selection process, and work closely with vendors (such as Dell, SuperMicro) for procurement and support.
Operating System Expertise: Demonstrate mastery of Linux and Microsoft Windows operating systems, including configuration, performance tuning, security hardening, and troubleshooting.
Open Source Solutions: Champion the use of open-source technologies to enhance efficiency and innovation. Lead the evaluation, implementation, and maintenance of open-source solutions in the compute domain.
Automation: Design and implement highly automated infrastructure solutions using configuration management tools such as Ansible and Terraform. Continuously improve deployment and management workflows leveraging CID/CD pipelines via Github.
Hybrid Cloud Expertise: Possess strong experience in both on-premises data center environments and cloud computing platforms. Seamlessly bridge cloud and traditional architectures.
Mentorship and Guidance: Mentor and develop junior engineers, foster a culture of technical excellence, promote industry best practices, and share knowledge across teams.
Required Qualifications
10+ years of hands-on experience in compute engineering within large-scale enterprise environments
7+ years deep proficiency and experience with Linux (Red Hat, CentOS, etc.) and Microsoft Windows operating systems
7+ years of proven hardware engineering experience with vendors such as Dell and SuperMicro
7+ years in depth experience designing and implementing solutions for virtualization, containerization, and cloud computing
3+ years experience with Ansible and other configuration management/automation tools
3+ years experience with networking concepts (DNS, TCP/IP, load balancing, etc.)
Preferred Qualifications
Experience with cloud platforms such as AWS, Azure, or GCP
Experience with data center consolidation
Knowledge of scripting languages (Python, Bash, etc.)
Experience with infrastructure-as-code tools (e.g., Terraform, CloudFormation)
Understanding of security best practices for compute environments
Advanced Degree in Computer Science, Information Systems, Engineering or related field
Exceptional analytical and troubleshooting skills with the ability to resolve complex technical problems quickly and efficiently
Excellent written and verbal communication skills. Ability to collaborate effectively with teams across the organization and advocate for technical solutions
Education
Bachelor’s degree or equivalent experience (High School Diploma and 4 years relevant experience)
Business Overview
Bring your heart to CVS Health Every one of us at CVS Health shares a single, clear purpose: Bringing our heart to every moment of your health. This purpose guides our commitment to deliver enhanced human-centric health care for a rapidly changing world. Anchored in our brand — with heart at its center — our purpose sends a personal message that how we deliver our services is just as important as what we deliver. Our Heart At Work Behaviors™ support this purpose. We want everyone who works at CVS Health to feel empowered by the role they play in transforming our culture and accelerating our ability to innovate and deliver solutions to make health care more personal, convenient and affordable. We strive to promote and sustain a culture of diversity, inclusion and belonging every day. CVS Health is an affirmative action employer, and is an equal opportunity employer, as are the physician-owned businesses for which CVS Health provides management services. We do not discriminate in recruiting, hiring, promotion, or any other personnel action based on race, ethnicity, color, national origin, sex/gender, sexual orientation, gender identity or expression, religion, age, disability, protected veteran status, or any other characteristic protected by applicable federal, state, or local law. We proudly support and encourage people with military experience (active, veterans, reservists and National Guard) as well as military spouses to apply for CVS Health job opportunities.
Pay Range
The typical pay range for this role is:
$144,200.00 – $288,400.00
This pay range represents the base hourly rate or base annual full-time salary for all positions in the job grade within which this position falls. The actual base salary offer will depend on a variety of factors including experience, education, geography and other relevant factors. This position is eligible for a CVS Health bonus, commission or short-term incentive program in addition to the base pay range listed above. This position also includes an award target in the company’s equity award program.
In addition to your compensation, enjoy the rewards of an organization that puts our heart into caring for our colleagues and our communities. The Company offers a full range of medical, dental, and vision benefits. Eligible employees may enroll in the Company’s 401(k) retirement savings plan, and an Employee Stock Purchase Plan is also available for eligible employees. The Company provides a fully-paid term life insurance plan to eligible employees, and short-term and long term disability benefits. CVS Health also offers numerous well-being programs, education assistance, free development courses, a CVS store discount, and discount programs with participating partners. As for time off, Company employees enjoy Paid Time Off (“PTO”) or vacation pay, as well as paid holidays throughout the calendar year. Number of paid holidays, sick time and other time off are provided consistent with relevant state law and Company policies.
NTT DATA Services strives to hire exceptional, innovative and passionate individuals who want to grow with us. If you want to be part of an inclusive, adaptable, and forward-thinking organization, apply now.
We are currently seeking a Certification Lead – Medicaid EVV to join our team in Oklahoma City, Oklahoma (US-OK), United States (US).
The Certification Lead will be responsible for providing specialized Certification leadership, knowledge, and expertise for an EVV (Electronic Visit and Verification) IT project. This position will learn and understand the client’s organization and the EVV solution and will lead an organized and coordinated federal certification effort.
The successful candidate for this position will work directly with contracted vendors, business users, our team, client leaders and stakeholders, and CMS to lead, support and coordinate all required CMS certification activities to ensure that the new system is successfully certified.
Job Responsibilities Include: • Lead the activities for maintaining the Outcomes Based Certification (OBC) status for the state. • Comply with 42 C.F.R. §§ 433.112(b)(15) and 433.116(b), (c), and (i), which requires states must be capable of producing data, reports, and performance information from and about their MES modules to facilitate evaluation, continuous improvement in business operations, and transparency and accountability, as a condition for receiving enhanced federal matching for MES expenditures. • Assist the state Medicaid Program in following CMS operational reporting process. • Submit metrics data in a timely manner. • Provide required information for Progress Reports. • Participate in Operational Readiness Review and Certification Final Review. • Comply with security and privacy requirements of the Health Insurance Portability and Accountability Act • Review project artifacts/deliverables throughout the system development life cycle for quality, compliance, and completeness, document observations and findings using project team processes and standards • Interface with state business users and vendors • Analyze technical, business and user needs, developing requirements documentation • Identify and report project issues and risks • Research and provide recommendations to the client on business problems/decisions • Collaborate with team members to provide subject matter expertise and assistance • Ensure project identified processes and methodologies are executed and followed • Develop and execute test cases • Develop and present formal presentations to business leaders, vendors, and team members, making applicable recommendations • Participate and/or lead in the creation of presentations and other materials for end user training
Required Qualifications: • Bachelor’s degree or equivalent experience • Minimum 8 years of total progressive work experience. • Minimum 2 years of experience leading certification efforts and managing certification processes and teams with large government, IT Projects in the State Health and Human Services (HHS) industry.
Preferred Skills: Experience working as a consultant. Electronic Visit Verification (EVV) Certification experience Experience translating Federal and State regulations into working requirements that are actionable by technical teams Experience working with Medicaid Enterprise Systems (MES) vendors Ability to translate between non-technical business users and technical IT resources
Where required by law, NTT DATA provides a reasonable range of compensation for specific roles. The starting pay range for this remote role is $89,000 to $145,000. This range reflects the minimum and maximum target compensation for the position across all US locations. Actual compensation will depend on a number of factors, including the candidate’s actual work location, relevant experience, technical skills, and other qualifications. This position may also be eligible for incentive compensation based on individual and/or company performance. This position is eligible for company benefits including medical, dental, and vision insurance with an employer contribution, flexible spending or health savings account, life and AD&D insurance, short and long term disability coverage, paid time off, employee assistance, participation in a 401k program with company match, and additional voluntary or legally-required benefits.
About NTT DATA Services
NTT DATA Services is a recognized leader in IT and business services, including cloud, data and applications, headquartered in Texas. As part of NTT DATA, a $30 billion trusted global innovator with a combined global reach of over 80 countries, we help clients transform through business and technology consulting, industry and digital solutions, applications development and management, managed edge-to-cloud infrastructure services, BPO, systems integration and global data centers. We are committed to our clients’ long-term success. Visit nttdata.com or LinkedIn to learn more.
NTT DATA Services is an equal opportunity employer and considers all applicants without regarding to race, color, religion, citizenship, national origin, ancestry, age, sex, sexual orientation, gender identity, genetic information, physical or mental disability, veteran or marital status, or any other characteristic protected by law. We are committed to creating a diverse and inclusive environment for all employees. If you need assistance or an accommodation due to a disability, please inform your recruiter so that we may connect you with the appropriate team.
Nearest Major Market: Oklahoma City Nearest Secondary Market: Oklahoma Job Segment: Consulting, Application Developer, Technology
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