Pharmaceutical Visa Sponsorship Jobs in Pennsylvania
Pennsylvania is one of the country's most active pharmaceutical hubs, anchored by major employers like Merck, GSK, Johnson & Johnson, and Pfizer across the Philadelphia region and suburban counties. International candidates in drug development, regulatory affairs, and clinical research will find meaningful visa sponsorship activity here, particularly along the I-95 corridor and in the Lehigh Valley.
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Get Access To All JobsJOB SUMMARY
This job is responsible for the daily activities of the Financial Investigations & Provider Review (FIPR) department with emphasis on pharmaceutical cases and initiatives. FIPR focuses on the detection and investigation of fraud, waste and abuse (FWA) and the recoupment of related overpayments related to the company’s provider spending. The incumbent will function as a key leader guiding all of the daily activities for a strategic unit within the department: The Pharmaceutical FWA unit. This job will be accountable for leading a team of investigators dedicated to cases and initiatives associated with pharmaceutical and drug related diversion, designated pharmacy programs, Medicare compliance mandates and other pharmaceutical related matters.
ESSENTIAL RESPONSIBILITIES
- Perform management responsibilities to include, but are not limited to: involved in hiring and termination decisions, coaching and development, rewards and recognition, performance management and staff productivity. Plan, organize, staff, direct and control the day-to-day operations of the department; develop and implement policies and programs as necessary; may have budgetary responsibility and authority.
- Delivers daily guidance to team leads and staff regarding case investigation activities including the development of detailed strategies for each case. Educates staff and management on regulatory and customer requirements regarding FIPR’s scope of activities and ensure adherence to these requirements.
- Provides direction to a team of investigators as members of a multi-stakeholder team responsible for monitoring drug utilization across the pharmacy and medical benefit with the goal of detecting and resolving instances of FWA.
- Develops action plans and priorities for various recovery opportunities with a focus on the continual increase in financial impact generated by pharmacy/prescriber investigations and analysis activities.
- Actively communicates and collaborates with management from various departments regarding impact on provider relations and reimbursement. Serves as subject matter expert for staff on the fraud investigation, facility and vendor audit and opportunity teams.
- Provide suggestions on and/or participate in department projects, process improvements, efficiency initiatives, system enhancements and policy and procedures to improve workflows.
- Serves in a variety of capacities in representing the department, including but not limited to such activities as:
- Working with audit vendors to refine their approaches and generate consistent increase in their recoveries
- Testifying when required in legal proceedings
- Collaborating with law enforcement in the pursuit of cases referred for prosecution
- Presenting provider/network appeal cases to Medical Review Committee (MRC); and/or providing technical expertise in evaluating/resolving cases.
- Interacting with external legal counsel regarding case inquiries
- Other duties as assigned or requested.
Education
Required
- Bachelor’s degree in Pharmacy or related field or relevant experience and/or education as determined by the company in lieu of bachelor's degree.
Preferred
- Master's Degree or above in Pharmacy or related field
Experience
Required
- 5 years of auditing, leading provider/facility audits and/or provider reimbursements, or in the health care industry with exposure to billing, coding
To Include:
- 3 years of clinical pharmacy management experience including drug use review activities, operational oversight and/or member engagement – knowledge of pharmacy/drug related FWA and experience working with law enforcement agencies (e.g. DEA)
- 1 year working with regulatory entities such as CMS, NCQA, HEDIS, and DOH etc.
Preferred
- 3 years in a managed care pharmacy and/or pharmacy benefit management (PBM)
- 1 year in managing or supervising clinicians (such as pharmacists, nurses, or other clinicians) in a utilization management operations setting in a PBM or Health Plan.
LICENSES or CERTIFICATIONS
Required
- Pharmacist License
Preferred
- None
SKILLS
- Strong analytic skills with ability to interpret, evaluate and act on productivity, clinical and financial data
- Strong leadership skills with demonstrated success in building effective, collaborative teams
- Ability to work in a high performing team environment that requires flexibility
- Strong and effective verbal and written communication skills; Effectively presents complex topics in a concise manner to audiences at various levels and various sizes; Demonstrates the ability to effectively persuade others to listen, commit, and act on a new approach
- Knowledge of hospital reimbursement strategies; medical technologies, hospital and provider office protocols, documentation requirements, State and Federal criminal and civil law related to insurance fraud and advances in the post-payment utilization review process
- Self-confident with an ability to accept and respond to challenges in a positive manner
- Broad understanding of business issues, metrics, organizational linkages and customer value
- Comprehensive knowledge of legal and investigative procedures used in the detection and successful resolution of health care fraud/abuse cases
Language (Other than English):
None
Travel Requirement:
0% - 25%
PHYSICAL, MENTAL DEMANDS and WORKING CONDITIONS
Position Type
Office-based
Teaches / trains others regularly
Occasionally
Travel regularly from the office to various work sites or from site-to-site
Rarely
Works primarily out-of-the office selling products/services (sales employees)
Never
Physical work site required
Yes
Lifting: up to 10 pounds
Constantly
Lifting: 10 to 25 pounds
Occasionally
Lifting: 25 to 50 pounds
Never
Disclaimer: The job description has been designed to indicate the general nature and essential duties and responsibilities of work performed by employees within this job title. It may not contain a comprehensive inventory of all duties, responsibilities, and qualifications required of employees to do this job.
Compliance Requirement: This job adheres to the ethical and legal standards and behavioral expectations as set forth in the code of business conduct and company policies.
As a component of job responsibilities, employees may have access to covered information, cardholder data, or other confidential customer information that must be protected at all times. In connection with this, all employees must comply with both the Health Insurance Portability Accountability Act of 1996 (HIPAA) as described in the Notice of Privacy Practices and Privacy Policies and Procedures as well as all data security guidelines established within the Company’s Handbook of Privacy Policies and Practices and Information Security Policy.
Furthermore, it is every employee’s responsibility to comply with the company’s Code of Business Conduct. This includes but is not limited to adherence to applicable federal and state laws, rules, and regulations as well as company policies and training requirements.
Highmark Health and its affiliates prohibit discrimination against qualified individuals based on their status as protected veterans or individuals with disabilities and prohibit discrimination against all individuals based on any category protected by applicable federal, state, or local law.
California Consumer Privacy Act Employees, Contractors, and Applicants Notice
JOB SUMMARY
This job is responsible for the daily activities of the Financial Investigations & Provider Review (FIPR) department with emphasis on pharmaceutical cases and initiatives. FIPR focuses on the detection and investigation of fraud, waste and abuse (FWA) and the recoupment of related overpayments related to the company’s provider spending. The incumbent will function as a key leader guiding all of the daily activities for a strategic unit within the department: The Pharmaceutical FWA unit. This job will be accountable for leading a team of investigators dedicated to cases and initiatives associated with pharmaceutical and drug related diversion, designated pharmacy programs, Medicare compliance mandates and other pharmaceutical related matters.
ESSENTIAL RESPONSIBILITIES
- Perform management responsibilities to include, but are not limited to: involved in hiring and termination decisions, coaching and development, rewards and recognition, performance management and staff productivity. Plan, organize, staff, direct and control the day-to-day operations of the department; develop and implement policies and programs as necessary; may have budgetary responsibility and authority.
- Delivers daily guidance to team leads and staff regarding case investigation activities including the development of detailed strategies for each case. Educates staff and management on regulatory and customer requirements regarding FIPR’s scope of activities and ensure adherence to these requirements.
- Provides direction to a team of investigators as members of a multi-stakeholder team responsible for monitoring drug utilization across the pharmacy and medical benefit with the goal of detecting and resolving instances of FWA.
- Develops action plans and priorities for various recovery opportunities with a focus on the continual increase in financial impact generated by pharmacy/prescriber investigations and analysis activities.
- Actively communicates and collaborates with management from various departments regarding impact on provider relations and reimbursement. Serves as subject matter expert for staff on the fraud investigation, facility and vendor audit and opportunity teams.
- Provide suggestions on and/or participate in department projects, process improvements, efficiency initiatives, system enhancements and policy and procedures to improve workflows.
- Serves in a variety of capacities in representing the department, including but not limited to such activities as:
- Working with audit vendors to refine their approaches and generate consistent increase in their recoveries
- Testifying when required in legal proceedings
- Collaborating with law enforcement in the pursuit of cases referred for prosecution
- Presenting provider/network appeal cases to Medical Review Committee (MRC); and/or providing technical expertise in evaluating/resolving cases.
- Interacting with external legal counsel regarding case inquiries
- Other duties as assigned or requested.
Education
Required
- Bachelor’s degree in Pharmacy or related field or relevant experience and/or education as determined by the company in lieu of bachelor's degree.
Preferred
- Master's Degree or above in Pharmacy or related field
Experience
Required
- 5 years of auditing, leading provider/facility audits and/or provider reimbursements, or in the health care industry with exposure to billing, coding
To Include:
- 3 years of clinical pharmacy management experience including drug use review activities, operational oversight and/or member engagement – knowledge of pharmacy/drug related FWA and experience working with law enforcement agencies (e.g. DEA)
- 1 year working with regulatory entities such as CMS, NCQA, HEDIS, and DOH etc.
Preferred
- 3 years in a managed care pharmacy and/or pharmacy benefit management (PBM)
- 1 year in managing or supervising clinicians (such as pharmacists, nurses, or other clinicians) in a utilization management operations setting in a PBM or Health Plan.
LICENSES or CERTIFICATIONS
Required
- Pharmacist License
Preferred
- None
SKILLS
- Strong analytic skills with ability to interpret, evaluate and act on productivity, clinical and financial data
- Strong leadership skills with demonstrated success in building effective, collaborative teams
- Ability to work in a high performing team environment that requires flexibility
- Strong and effective verbal and written communication skills; Effectively presents complex topics in a concise manner to audiences at various levels and various sizes; Demonstrates the ability to effectively persuade others to listen, commit, and act on a new approach
- Knowledge of hospital reimbursement strategies; medical technologies, hospital and provider office protocols, documentation requirements, State and Federal criminal and civil law related to insurance fraud and advances in the post-payment utilization review process
- Self-confident with an ability to accept and respond to challenges in a positive manner
- Broad understanding of business issues, metrics, organizational linkages and customer value
- Comprehensive knowledge of legal and investigative procedures used in the detection and successful resolution of health care fraud/abuse cases
Language (Other than English):
None
Travel Requirement:
0% - 25%
PHYSICAL, MENTAL DEMANDS and WORKING CONDITIONS
Position Type
Office-based
Teaches / trains others regularly
Occasionally
Travel regularly from the office to various work sites or from site-to-site
Rarely
Works primarily out-of-the office selling products/services (sales employees)
Never
Physical work site required
Yes
Lifting: up to 10 pounds
Constantly
Lifting: 10 to 25 pounds
Occasionally
Lifting: 25 to 50 pounds
Never
Disclaimer: The job description has been designed to indicate the general nature and essential duties and responsibilities of work performed by employees within this job title. It may not contain a comprehensive inventory of all duties, responsibilities, and qualifications required of employees to do this job.
Compliance Requirement: This job adheres to the ethical and legal standards and behavioral expectations as set forth in the code of business conduct and company policies.
As a component of job responsibilities, employees may have access to covered information, cardholder data, or other confidential customer information that must be protected at all times. In connection with this, all employees must comply with both the Health Insurance Portability Accountability Act of 1996 (HIPAA) as described in the Notice of Privacy Practices and Privacy Policies and Procedures as well as all data security guidelines established within the Company’s Handbook of Privacy Policies and Practices and Information Security Policy.
Furthermore, it is every employee’s responsibility to comply with the company’s Code of Business Conduct. This includes but is not limited to adherence to applicable federal and state laws, rules, and regulations as well as company policies and training requirements.
Highmark Health and its affiliates prohibit discrimination against qualified individuals based on their status as protected veterans or individuals with disabilities and prohibit discrimination against all individuals based on any category protected by applicable federal, state, or local law.
California Consumer Privacy Act Employees, Contractors, and Applicants Notice
Pharmaceutical Job Roles in Pennsylvania
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Search Pharmaceutical Jobs in PennsylvaniaPharmaceutical Jobs in Pennsylvania: Frequently Asked Questions
Which companies sponsor visas for pharmaceutical jobs in Pennsylvania?
Pennsylvania's largest pharmaceutical visa sponsors include Merck (Upper Gwynedd), GSK (Philadelphia and Upper Providence), Johnson & Johnson (Spring House), and West Pharmaceutical Services (Exton). Contract research organizations like ICON and Syneos Health also operate in the region and have documented histories of H-1B visa sponsorship for roles in clinical research, regulatory affairs, and pharmaceutical sciences.
Which visa types are most common for pharmaceutical roles in Pennsylvania?
The H-1B is the most common visa for pharmaceutical professionals in Pennsylvania, covering roles like formulation scientist, regulatory affairs specialist, pharmacokineticist, and biostatistician that require a relevant bachelor's degree or higher. Candidates with advanced research credentials sometimes pursue the O-1A for extraordinary ability. Those entering from Canada or Mexico in qualifying scientific roles may be eligible for the TN visa under NAFTA/USMCA.
Which cities in Pennsylvania have the most pharmaceutical sponsorship jobs?
The Philadelphia metropolitan area, including suburban counties like Montgomery, Chester, and Bucks, concentrates the vast majority of Pennsylvania's pharmaceutical sponsorship activity. Upper Gwynedd, Spring House, Lansdale, and West Point are home to major research and manufacturing campuses. The Lehigh Valley, particularly around Allentown and Bethlehem, also has a growing presence of specialty pharma and contract manufacturing organizations that actively hire international candidates.
How to find pharmaceutical visa sponsorship jobs in Pennsylvania?
Migrate Mate filters job listings specifically for roles where employers have demonstrated visa sponsorship willingness, including pharmaceutical positions across Pennsylvania. You can search by role type, such as regulatory affairs or clinical development, and filter to Pennsylvania to surface relevant openings from companies with active sponsorship histories in the state. This is a more targeted approach than browsing general-purpose boards where sponsorship availability is rarely disclosed upfront.
Are there any state-specific considerations for pharmaceutical candidates seeking sponsorship in Pennsylvania?
Pennsylvania's concentration of research universities, including Penn, Drexel, and Temple, creates strong local pipelines into pharmaceutical employers that are experienced with OPT extensions and H-1B transitions for international graduates. The state's pharma sector is heavily regulated and degree-specific, so sponsoring employers typically require that your academic field aligns directly with the role, which USCIS scrutinizes closely under the specialty occupation standard.
What is the prevailing wage for sponsored pharmaceutical jobs in Pennsylvania?
U.S. employers sponsoring a visa must pay at least the prevailing wage, which is what workers in the same role, area, and experience level typically earn. The Department of Labor sets this rate to make sure companies aren't hiring foreign workers simply because they'd accept lower pay than a U.S. worker. It varies by job title, location, and experience. You can look up current prevailing wage rates for any occupation and location using the OFLC Wage Search page.