- Humana (Columbus, OH)
- … point of sale transition adjudicated claims logic. The Senior Pharmacy Claims Operations Professional work assignments involve moderately complex ... caring community and help us put health first** The Senior Pharmacy Claims Operations Professional... claims adjudication logic as it pertains to pharmacy transition point of sale claims… 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 ... or forwards/escalates to other departments or PBM. Monitors paid claims for accuracy including for transition supply...Part D ( pharmacy ). . Strong knowledge of pharmacy claims processing through retail or mail… more
- Mount Sinai Health System (New York, NY)
- …data from PBM prescription portal for QA report and analyzing + Reviewing pharmacy claims to identify outliers, utilization and prescribing trends + Adhoc ... in the NY/NJ region. MSHS, World Trade Center Health Program (WTCHP) seeks a Clinical Pharmacy Manager that reports to Senior Manager, Pharmacy Benefits and… 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
- Humana (Columbus, OH)
- …to maximize ability of limited resources to achieve growth. **The Senior Strategy Advancement Professional** will support initiatives to develop and execute ... assess, and translate state requirements into actionable go-to-market strategy. The Senior Strategy Advancement Professional will consult with growth partners to… more