Top 93 Sr. manager, pricing pharmacy appeals Jobs in North Dakota

Sr. Manager, Pricing - Pharmacy Appeals
CVS Health —North Dakota
- $67,900 - $182,549 a year
- Full-time
- Remote
- 7 years
- Microsoft Access
- Office
- Health insurance
- Dental insurance
Sr Manager - Operations
Energy Transfer Partners —Watford City, ND
- Full-time
- Bachelor of Science
- Office
- Bachelor's degree
- Profit sharing
- Paid time off
Quick Apply
Resident Care Manager, RN - Senior Living
Eventide —West Fargo, ND
- Nursing
- RN License
- Mid-level
Quick Apply
Senior Electrical Project Manager (Data Centers)
Everforth, Cybercoders —West Fargo, ND
- $160,000 - $190,000 a year
- Full-time
- 7 years
- Construction site
- US work authorization
Quick Apply
Scrum Master Senior Manager
Eide Bailly LLP —Fargo, ND
- $155,000 - $195,000 a year
- Full-time
- Remote
- Bachelor's degree
- Mentoring
- US work authorization
- Profit sharing
- Disability insurance
Senior Program Manager / Project Manager - Medicaid Claims
CVS Health —North Dakota
- $106,605 - $284,280 a year
- Full-time
- Remote
- Bachelor's degree
- Mentoring
- Fair chance
- Health insurance
- Dental insurance
Senior Manager Parcel Insights and Pricing
Ryder System —Bismarck, ND
- $130,000 - $150,000 a year
- Hybrid work
- Management
- Finance
- Bachelor's degree
- Disability insurance
- Health insurance
Sr. Operations Manager
Amazon.com Services LLC —Fargo, ND
- $121,500 - $164,400 a year
- Full-time
- Mid-level
- Bachelor's degree
- Mentoring
- AD&D insurance
- Health insurance
5h
Alternative Health & Advocacy Solutions COE Senior Project Manager
CVS Health —North Dakota
- $67,900 - $199,144 a year
- Full-time
- Remote
- 7 years
- Presentation skills
- Bachelor's degree
- Health insurance
- Dental insurance
Senior Manager – Operations Readiness
CVS Health —North Dakota
- $67,900 - $182,549 a year
- Full-time
- Remote
- 5 years
- Bachelor's degree
- Fair chance
- Health insurance
- Dental insurance
13h
Senior Manager, Digital Product
CVS Health —North Dakota
- $106,605 - $284,280 a year
- Full-time
- Remote
- 7 years
- Bachelor's degree
- Product management
- Health insurance
- Dental insurance
Senior Manager, Strategic Planning (IC)
CVS Health —North Dakota
- $67,900 - $199,144 a year
- Full-time
- Remote
- 6 years
- Bachelor's degree
- Fair chance
- Health insurance
- Dental insurance
13d
Sr. Business Development Manager, Clinical Solutions & Licensing
American Heart Association —Bismarck, ND
- $135,000 - $145,000 a year
- Full-time
- 8 years
- Bachelor's degree
- Fair chance
- Wellness program
- Paid holidays
8d
Senior Manager Finance - REMOTE
Ryder System —Bismarck, ND
- $110,000 - $130,000 a year
- Full-time
- Remote
- Microsoft Excel
- Finance
- 8 years
- Disability insurance
- Health insurance
Senior Program Manager (mRNA LNP, Drug Product CMC/Development)
Aldevron —Fargo, ND
- $150,000 - $170,000 a year
- Full-time
- Remote
- Bachelor of Science
- Analysis skills
- Continuous improvement
- Health insurance
- Dental insurance
Senior Manager, Mental Well-being Operations Innovation
CVS Health —North Dakota
- $67,900 - $199,144 a year
- Full-time
- Remote
- 7 years
- SQL
- Analysis skills
- Health insurance
- Dental insurance
Senior Project Manager Meritain TPA
CVS Health —Bismarck, ND
- $67,900 - $199,144 a year
- Full-time
- Remote
- Bachelor's degree
- Continuous improvement
- Organizational skills
- Health insurance
- Dental insurance
12d
Senior Product Leader - Program Management
U.S. Bank National Association —Fargo, ND
- $149,515 - $175,900 a year
- Full-time
- Office
- Product management
- US work authorization
- Paid holidays
- Disability insurance
Senior Client Operations Manager
Arvato —Fargo, ND
- Online Application
- 7 years
- Microsoft Excel
- Bachelor of Science
- Commuter assistance
- Paid holidays
Quick Apply
Senior Manager, Commercial Product Execution
CVS Health —Bismarck, ND
- $67,900 - $199,144 a year
- Full-time
- Hybrid work
- 7 years
- Bachelor's degree
- Organizational skills
- Health insurance
- Dental insurance
7d

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sr. manager, pricing pharmacy appeals jobs near north dakota

Sr. Manager, Pricing - Pharmacy Appeals

CVS Health -
North Dakota

Apply Now

Job Details

Full-time
$67,900 - $182,549 a year

Benefits

Health insurance
Dental insurance
Paid time off
Vision insurance

Qualifications

Appeals
Pricing strategies
Regulatory compliance in claims processing
State healthcare regulations
Case appeal in utilization management
Business management
Business operations
Insurance claims appeal handling
Healthcare compliance
Senior leadership
Analytics

Full Job Description

We’re building a world of health around every individual — shaping a more connected, convenient and compassionate health experience. At CVS Health®, you’ll be surrounded by passionate colleagues who care deeply, innovate with purpose, hold ourselves accountable and prioritize safety and quality in everything we do. Join us and be part of something bigger – helping to simplify health care one person, one family and one community at a time.

Position Summary
The Senior Manager, Pricing will lead a team colleagues and contractors in the management of specific functions related pharmacy reimbursement appeals including the Service Warranty process as well as supporting the Department of Insurance and Secondary Appeals operations. In this role, you will ensure the appeals are executed under tight Turnaround Times (TATs) and with high accuracy while making sure the team is appropriately staffed and organized. In addition, you will be responsible for developing and implementing solutions individually and being a lead working with partners to improve and automate processes to increase productivity and fulfill state regulatory changes. You will be leading and coaching the appeal team coordinators as well as guiding other internal business units to resolve issues quickly. The Senior Manager, Pricing is also responsible for working legal and compliance team to ensure state regulatory updates are operationalized. This role requires a thorough knowledge of claim adjudication, appeals related processes, and being a leader working with other internal business units to develop new solutions to meet the ever-increasing number of complex appeal bill compliance requirements. The position will be responsible for quality control process to ensure compliance.

What you will do

Leads with strategic leadership and guidance to pharmacy reimbursement appeals teams, ensuring effective strategies and operations are effectively progressed to improve performance.
Oversees pharmacy appeals service warranty process to ensure timely processing and compliance with state regulations
Reviews and responds to complex inquiries related to pharmacy reimbursement appeals submitted by state regulators and pharmacies.
Analyzes market trends, and competitive insights to generate actionable recommendations.
Collaborates cross-functionally with legal, finance, and account teams to align client strategies with business goals, enhance value propositions, and optimize appeals services.
Influences stakeholders through effective communication and negotiation, leveraging operations expertise and industry knowledge to establish mutually beneficial partnerships and agreements.
Applies experienced-based pharmacy claims and appeals knowledge and insights to influence strategic decision-making.
Counsels and mentors team members, providing guidance and support to enhance their skills and professional development.

Required Qualifications

7 year’s experience in pricing, PBM/healthcare operations, process improvement, quality, analytics, or related domains
5+ years directly leading operations teams
1+ years’ experience with pharmacy appeal related processes and state regulations, and claims adjudication, including claims adjudication logic

Preferred Qualifications

Excellent leadership skills
Proficient in Excel, MS Access, Salesforce, and Pharmacy Portal
Ability to work under tight deadlines
Strong mathematical problem-solving skills
Prior PBM Knowledge
Familiarity with wholesaler invoices

Education

Bachelor’s Degree or equivalent experience required.

Pay Range

The typical pay range for this role is:

$67,900.00 - $182,549.00

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.

Our people fuel our future. Our teams reflect the customers, patients, members and communities we serve and we are committed to fostering a workplace where every colleague feels valued and that they belong.

Great benefits for great people

We take pride in offering a comprehensive and competitive mix of pay and benefits that reflects our commitment to our colleagues and their families.

This full‑time position is eligible for a comprehensive benefits package designed to support the physical, emotional, and financial well‑being of colleagues and their families. The benefits for this position include medical, dental, and vision coverage, paid time off, retirement savings options, wellness programs, and other resources, based on eligibility.

Additional details about available benefits are provided during the application process and on Benefits Moments.

We anticipate the application window for this opening will close on: 08/31/2026

Qualified applicants with arrest or conviction records will be considered for employment in accordance with all federal, state and local laws.

Apply Now

Refine Your Search

sr. manager, pricing pharmacy appeals jobs in north dakota

Sr. Manager, Pricing - Pharmacy Appeals

Sr Manager - Operations

Resident Care Manager, RN - Senior Living

Senior Electrical Project Manager (Data Centers)

Scrum Master Senior Manager

Senior Program Manager / Project Manager - Medicaid Claims

Senior Manager Parcel Insights and Pricing

Sr. Operations Manager

Alternative Health & Advocacy Solutions COE Senior Project Manager

Senior Manager – Operations Readiness

Senior Manager, Digital Product

Senior Manager, Strategic Planning (IC)

Sr. Business Development Manager, Clinical Solutions & Licensing

Senior Manager Finance - REMOTE

Senior Program Manager (mRNA LNP, Drug Product CMC/Development)

Senior Manager, Mental Well-being Operations Innovation

Senior Project Manager Meritain TPA

Senior Product Leader - Program Management

Senior Client Operations Manager

Senior Manager, Commercial Product Execution

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