Manager, Pharmacy Pricing Appeals
Capital Rx
full-time
Posted on:
Location Type: Hybrid
Location: Charlotte • Colorado • New York • United States
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Salary
💰 $95,000 - $130,000 per year
About the role
- Lead the review and improvement of the pharmacy pricing appeal process.
- Manage intake pharmacy pricing appeals or claims reviews.
- Collaborate with pharmacies and internal teams to reach equitable reimbursement outcomes.
- Maintain accurate records of appeals and generate reports on trends and discrepancies.
Requirements
- Bachelor’s degree required.
- 5+ yrs. of experience in reviewing claims or payment appeals in healthcare, pharmacy, PBM, or other relevant experience.
- In-depth knowledge of pharmacy operations and drug pricing.
- Familiarity with PBMs and their role in pharmacy reimbursement.
- Strong analytical and problem-solving skills.
- Strong project management skills.
- Excellent communication and interpersonal abilities.
- Intermediate level of proficiency with Microsoft Excel, Word, PowerPoint.
Benefits
- Health insurance
- Retirement plans
- Paid time off
- Flexible work arrangements
Applicant Tracking System Keywords
Tip: use these terms in your resume and cover letter to boost ATS matches.
Hard Skills & Tools
claims reviewpayment appealspharmacy operationsdrug pricinganalytical skillsproblem-solving skillsproject management
Soft Skills
communication abilitiesinterpersonal abilities