- Christus Health (San Antonio, TX)
- DescriptionSummary: The Registered Nurse Patient Navigator Lead is a Registered Nurse or licensed Nurse Practitioner who provides health and wellness coaching, case ... CHRISTUS services. These services will be provided by monitoring cases and claims , analyzing biometric and health risk assessment data, organizing disease management… more
- Elevance Health (Columbus, OH)
- …needs to determine insights identifying cost of care and quality opportunities using pharmacy claims . + Determines specific data needs to address specific ... efficient data storage and retrieval preferred. + Experience pulling pharmacy claims from EDW preferred. + Proficient...is designed to advance our strategy but will also lead to personal and professional growth for our associates.… more
- Mount Sinai Health System (New York, NY)
- …as required for referred patients 3. Aids in quality assurance process on WTCHP pharmacy claims 4. Assists in answering pharmacy benefit questions. 5. ... direct supervision of the World Trade Center Health Program (WTCHP) Clinical Pharmacy Manager, this World Trade Center Pharmacy Benefits Coordinator interacts… more
- Colorado State University (Fort Collins, CO)
- …Completing required spreadsheets for casual sales + Managing expired medication + Assisting the lead pharmacy technician with order points on drugs + Help keep ... Strong customer service skills + Expert in processing insurance claims , handling rejections, and prior authorizations Knowledge, Skills, Abilities,...+ Takes on additional tasks and projects assigned by pharmacy manager and lead pharmacy … 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 ... claims adjudication, drug pricing, and reimbursement + Support financial , quality and utilization analytics and performance improvement evaluations Responsibility… more
- Trinity Health (Fort Wayne, IN)
- …or physician of results when needed. 5. Adjudicates and reviews prescription insurance claims and patient financial assistance plans of medications to be ... **POSITION PURPOSE - located in Fort Wayne, Indiana** The Patient Assistance Pharmacy Technician in Training will participate in a work learning program to… more
- SSM Health (Monroe, WI)
- …reconcile pharmacy claims . + Assists in the development of the pharmacy budget. Reviews monthly financial and human resource budget and explain variances ... Clinic Hospital **Worker Type:** Regular **Job Highlights:** Join the SSM team and lead the way in transforming pharmacy services! Your strategic insight and… more
- Walgreens (Ramsey, NJ)
- …and supports the pharmacy manager in analyzing performance data including pharmacy financial , customer service, and implementation of procedures for ... **Job Description:** **Job Summary:** Engages in post-graduate pharmacy activities under direct supervision of licensed pharmacist to fulfill the State Board of … more
- UPMC (Pittsburgh, PA)
- **UPMC Mercy is hiring a Full-Time Pharmacy Technician, Intermediate to support our Pharmacy department!** This position will work rotating shifts primarily ... Sign On Bonus of $5,000 with a 2 year commitment to UPMC. Pharmacy Technician career advancement and certification opportunity available through completion of a free… more
- PruittHealth (Norcross, GA)
- **Billing, Collections and Posting Professional** Pruitt Health Home Infusion pharmacy is looking for an experienced and motivated Billing, Collections and Posting ... QA to insure accurate and timely creation of new claims and insures submitted claims meet payer...staff. **Collections** Strong skills and knowledge in home infusion pharmacy collections and timely follow ups with insurance companies… more
- Deloitte (Costa Mesa, CA)
- …business terms) with PBMS + Experience performing analytical analysis of medical & pharmacy claims , including understanding financial impact of network ... consider a career in Deloitte's Human Capital practice. Work you'll do + Lead employee benefits diagnostic/planning studies, especially in pharmacy + Provide… more
- Elevance Health (Woburn, MA)
- ** Pharmacy Quality Improvement Specialist** _This position will work a hybrid model (remote and office), 1-2 times per week. The Ideal candidate will live within 50 ... new technologies and a strong, clinical-first lens, to deliver member-centered, lasting pharmacy care. The Pharmacy Quality Improvement Specialist is responsible… more
- Elevance Health (Austin, TX)
- …pharmacies, our infusion centers, and the home setting. **Title** : Clerk I ( Pharmacy Assistant) **Location** : **8601 Cross Park Dr. Suite 400, Austin, TX 78754** ... **Build the Possibilities. Make an Extraordinary Impact.** The **Clerk I ( Pharmacy Assistant)** is responsible for providing basic clerical activities in support… more
- Elevance Health (Altamonte Springs, FL)
- **Be Part of an Extraordinary Team** _BioPlus Specialty Pharmacy is now part of CarelonRx (formerly IngenioRx), and a proud member of the Elevance Health family of ... interpreting plan design, researching and resolving phone and written inquiries, resolving claims , benefit and enrollment issues. + Makes routine account visits. +… more
- Elevance Health (Altamonte Springs, FL)
- **Be Part of an Extraordinary Team** BioPlus Specialty Pharmacy is now part of CarelonRx (formerly IngenioRx), and a proud member of the Elevance Health family of ... plan design, researching and resolving phone and written inquiries, resolving claims , benefit, and enrollment issues. + Prepares and submits contractually required… more
- BrightSpring Health Services (Vineland, NJ)
- …Assistance/Reimbursement + Employee Discount Program + 401k + Paid-time off Our Pharmacy group focuses on providing exceptional customer service and meeting the ... pharmacy needs for hospitals, rehabilitation hospitals, long-term acute care...Identifies and resolves issues of denials or follow-up of claims . + Maintains current knowledge of Medicaid claim regulations… more
- The Cigna Group (Seattle, WA)
- …contractual requirements. **ESSENTIAL FUNCTIONS** + Perform efficient and effective network pharmacy claims audits to produce results consistent with ... professional input to complex Quality Assurance/Audit assignments/projects to identify pharmacy audit risks. Works autonomously, only requiring "expert" level… more
- Omnicell (Fort Worth, TX)
- …insurance, retirement, educational, and well-being programs to ensure quality, value, and financial protection to help you and your family live well. **In-Office ... Worth, TX 76137 **Day in the Life:** As a Lead Reconciliation Analyst, you'll serve as the primary liaison...for independent pharmacies. Your role will involve engaging with pharmacy owners, accountants, pharmacy technicians, and other… more
- Baptist Memorial (Collierville, TN)
- …and maintains financial records. + Provides training and guidance to pharmacy interns throughout course of their work and monitoring their performance. + Takes ... Summary Provides pharmacy consulting services to customers regarding the effective...promote productivity. + Ensures the accurate processing of insurance claims to resolve customer issues and prevent payment rejections.… more
- Molina Healthcare (GA)
- …and Medicare/MMP. + Analysis and reporting related to Managed care data like Medical Claims , Pharmacy , Lab and HEDIS rates. + Assist Quality department with ... **Job Description** **Job Summary** The Lead Analyst, Quality Analytics and Performance Improvement role will support Molina's Quality Analytics team. Designs and… more
