- Daiichi Sankyo, Inc. (Bernards, NJ)
- …Department as well as serving as a mentor in order to foster their professional growth and development as well as their achievement of Company and/or departmental ... expectations and goals as identified by senior management.Responsibilities- Lead drafting and negotiating contracts for commercial, Medicaid and Medicare coverage,… more
- CenterWell (Columbus, OH)
- **Become a part of our caring community and help us put health first** The Pharmacy Claims Representative 2 adjudicates pharmacy claims and process ... pharmacy claims for payment. The Pharmacy Claims Representative 2 performs varied activities...at the center. As the nation's largest provider of senior -focused primary care, one of the largest providers of… more
- Medical Mutual of Ohio (OH)
- … Technician (CPhT) preferred. . Knowledge of CMS guidelines and Medicare Part D ( pharmacy ). . Knowledge of pharmacy claims processing through retail or ... oversight process questions. . Performs other duties as assigned. ** Senior Medicare Pharmacy Coordinator** Working under limited...Part D ( pharmacy ). . Strong knowledge of pharmacy claims processing through retail or mail… more
- CenterWell (Atlanta, GA)
- …caring community and help us put health first** As a **Healthcare Claims Denials Specialist/Accounts Receivable Specialist** , you will: + Ensure the coordination ... timely reimbursement of receivables. + Research, resolve, and prepare claims that have not passed the payer edits daily....at the center. As the nation's largest provider of senior -focused primary care, one of the largest providers of… more
- BrightSpring Health Services (Wilkes Barre, PA)
- … solution providing value beyond medication. PharMerica is the long-term care pharmacy services provider of choice for senior living communities, skilled ... focus on fulfilling the pharmaceutical needs of our long-term care and senior living clients. We offer a non-retail pharmacyenvironment. Our organization is inhigh… more
- Humana (Columbus, OH)
- …focus of this role is Medicare Pharmacy and Part D. The Senior Compliance Professional will analyze business requirements, provide research and regulatory ... caring community and help us put health first** The Senior Compliance Professional ensures compliance with governmental...care industries + Strong communication skills + Experience with pharmacy operations and/or claims processing in a… more
- Sharp HealthCare (San Diego, CA)
- …the position, and employer business practices. **What You Will Do** This Senior Medical Director position provides critical management and oversight for Sharp Health ... of our members related to their medical, behavioral health and pharmacy needs. This position also provides the physician cohesive collaboration necessary… more
- CVS Health (Columbus, OH)
- …people on their path to better health as part of the largest integrated pharmacy company in the United States. Through the company's more than 7,600 CVS/ pharmacy ... a market leader in mail order, retail and specialty pharmacy , retail clinics, and Medicare Part D Prescription Drug...be responsible for: Managing a high volume of medical claims that have denied by refuting the denials within… more
- Elevance Health (Louisville, KY)
- …referral, and use of proprietary data and claim systems for review of facility, professional and pharmacy claims . + Responsible for independently identifying ... **Investigator Senior ** **Supports the Payment Integrity line of business**...to recover corporate and client funds paid on fraudulent claims . Health insurance experience required with understanding of health… more
- Elevance Health (Indianapolis, IN)
- …referral, and use of proprietary data and claim systems for review of facility, professional and pharmacy claims . + Responsible for independently identifying ... ** Senior Investigator (Investigator Sr)** _Location: This position will...to recover corporate and client funds paid on fraudulent claims . **How you will make an impact:** + Claim… more
- Walgreens (Deerfield, IL)
- **Job Description:** **Job Summary** As Senior Counsel, Employment Law and Benefits, you will play an integral role in helping a highly complex, fast paced ... varying levels on wage and hour matters, workplace accommodations, protected leave, claims of harassment, discrimination, paid sick leave and benefits support and… more
- CVS Health (Albany, NY)
- …and compliance. This Independent contributor requires deep expertise in medical, dental and pharmacy claims operations, as well as a thorough understanding of ... or analytics development. + Strong understanding of medical, dental, and pharmacy claims processing, coding practices, and reimbursement methodologies. +… more
- Humana (Columbus, OH)
- …informaticists to define various clinical concepts and extract clinical information from medical, pharmacy , and lab claims for analytics and modeling purposes + ... + Healthcare or managed care working experience + Experience working with medical, pharmacy , lab claims + Experience working with big data and using… more
- The County of Los Angeles (Los Angeles, CA)
- SENIOR INFORMATION SYSTEMS ANALYST (Electronic Health Record) Print (https://www.governmentjobs.com/careers/lacounty/jobs/newprint/3124187) Apply SENIOR ... applications; or ancillary services applications such as lab, radiology, and pharmacy . Provides technical leadership in IT strategic planning, business automation… more
- Amgen (Washington, DC)
- …us and transform the lives of patients while transforming your career. ** Senior Associate, Patient Access, Inflammation, Specialty Channel** **What you will do** ... In this vital role you will support the Specialty Pharmacy (SP) Channel Team in execution of Patient Access...+ Lead tracking of all access related marketing messages, claims , and Data On file (DOF) and manage Channel… more
- VHC Health (Alexandria, VA)
- Senior Epic Resolute Hospital Billing Analyst II Job Description Purpose & Scope: This position is responsible for leading, coordinating, and supporting the ... of the Epic hospital billing module installation. Responsibilities include serving as the senior point of contact with clinical areas that are the primary users of… more
- CVS Health (Hartford, CT)
- …convenient and affordable. **Position Summary** We are seeking an experienced Senior Healthcare Fraud Investigator to join our Special Investigations Unit (Aetna ... abuse. + Conduct Investigations to prevent payment of suspect or fraudulent claims submitted by insured's, providers, claimants, and customers. + Researches and… more
- Deloitte (San Francisco, CA)
- Life Sciences Market Access Senior Manager An evolving customer and regulatory landscape, mounting pipeline of next-gen assets and portfolio pressures, and ... + Lead team in development of quantitative and/or qualitative analysis (eg, claims data analysis, market research data) to drive meaningful insights for our… more
- The Cigna Group (Jefferson City, MO)
- …activity and operational needs for issue resolution in eligibility, claims , implementations, participant materials, report requests, and general inquiries for ... * Proficient in Microsoft PowerPoint with the ability to create professional and visually appealing presentations. * Excellent verbal and written communication… more
- Atrius Health (Newton, MA)
- …of changes for financial statement reporting. Makes recommendations and provides critical professional expertise to inform senior management of amounts to record ... aspects of assessing, evaluating, and estimating outside medical expenses and claims data warehouse for Optum Massachusetts. Responsible for complex trend analysis… more
