Head of Pharmacy Fraud & Network Integrity

Horizon-Blue-Cross-Blue-Shield-of-New-Jersey; Newark (NJ); Híbrido; USD 110.000 - 150.000; Jornada completa

Ventajas ofrecidas por este puesto de trabajo

Hybrid Schedule

Comprehensive health benefits

Retirement Plans

Generous PTO

Incentive Plans

Wellness Programs

Paid Volunteer Time Off

Tuition Reimbursement

Descripción de la vacante

Horizon Blue Cross Blue Shield of New Jersey seeks a Pharmacist leader to oversee the Pharmacy Fraud, Waste and Abuse program. You will coordinate with regulatory agencies, design utilization management edits, and lead audits and staff training to ensure compliance and program effectiveness.

Ideal candidates hold a PharmD with NJ licensure, 5+ years in pharmaceutical practice, and 3+ years in pharmacy auditing or managed care. The role is hybrid, with travel across New Jersey for audits.

Educación

Pharmacy degree (PharmD)

Descripción del empleo

Horizon Blue Cross Blue Shield of New Jersey seeks a Pharmacist leader to oversee the Pharmacy Fraud, Waste and Abuse program. You will coordinate with regulatory agencies, design utilization management edits, and lead audits and staff training to ensure compliance and program effectiveness.

Ideal candidates hold a PharmD with NJ licensure, 5+ years in pharmaceutical practice, and 3+ years in pharmacy auditing or managed care. The role is hybrid, with travel across New Jersey for audits.