- Marshfield Clinic (Marshfield, WI)
- …law and third-party reimbursement rules. **Preferred/Optional:** Three years' experience in pharmacy claims processing. Experience in technical writing and ... to support the most exciting missions in the world!** **Job Title:** Pharmacy Systems Support Specialist Senior **Cost Center:** 301641560 System Ancillary… more
- AbbVie (North Chicago, IL)
- …drug therapy orders, interpreting and dispensing prescriptions, maintaining patient and pharmacy records and other professional activities. This position is ... handling/documentation; prescription data entry; high quality customer service and inter- professional communication; strong core insurance (Medical and Pharmacy … more
- Centene Corporation (Austin, TX)
- …a Monday - Friday; 2:00 pm - 10:30 pm EST, schedule.** **Position Purpose:** The Senior Pharmacy Resolution Specialist will act as a subject matter expert and ... everything for our 28 million members as a clinical professional on our Medical Management/Health Services team. Centene is...handles more complex pharmacy issues and respond to escalated calls from members,… more
- Elevance Health (Mason, OH)
- **Manager Senior Engineering for Healthcare ( Pharmacy ) Applications** **Location:** This role requires associates to be in-office 2-3 days per week, fostering ... accommodation is granted as required by law. The **Manager Senior Engineering for Healthcare ( Pharmacy ) Applications i**...will make an impact:** + Focuses efforts on lowering claims costs, improving the quality of care, and increasing… more
- BD (Becton, Dickinson and Company) (Durham, NC)
- …devices. The position may directly or indirectly (matrix) manage supervisors, professional employees, business support, or technical staff. **Job Description** We ... employee coaching, mentorship, and supervision of support and entry-level professional associates. + Applies expertise to improve effectiveness and provide… more
- Henry Ford Health System (Detroit, MI)
- …claim defense costs and management of System reputation Will work under the guidance of Senior Claims Managers, Senior Claims Consultant, Director of ... DESCRIPTION: Provide key system role in professional and general liability, workers compensation and employers liability claims review, investigation, management… more
- CenterWell (Atlanta, GA)
- …organization's pre-billing function. This role is responsible for ensuring all claims are audit-ready prior to release, driving standardization across branches, and ... compliance. The Manager leads a team of Pre-Bill Specialists, partners with senior leadership, and champions initiatives that enable scale and reduce variation in… more
- Walgreens (Lawrenceville, GA)
- **Job Description:** Our pharmacy technician positions have undergone an exciting transformation, moving from a transaction-based environment to a much more ... patient-centric one. As a Walgreens Pharmacy Technician or Pharmacy Technician Apprentice, you'll...those to physicians. + Processes (corrects and resubmits) manual claims for third party program prescription services in a… more
- BrightSpring Health Services (Hilo, HI)
- …capable and motivated individual to join our team. PharMerica is a non-retail pharmacy that focuses on providing exceptional customer service and meeting the ... pharmacy needs for hospitals, rehabilitation facilities, long-term acute care...Identifies and resolves issues of denials or follow-up of claims , by maintaining current knowledge of Medicaid claim… more
- State of Massachusetts (Boston, MA)
- …vehicles deemed appropriate to inform the Division's various audiences. The Director of Pharmacy Benefit Manager Oversight is a senior management level position ... be required to evaluate carriers' compliance with coding and claims practices. * Oversee the licensure of Pharmacy...to MGL c. 176Y. * Coordinate and communicate with senior management staff to ensure that staff are aware… more
- UHS (Johnson City, NY)
- …Provide immunizations and other health screenings in compliance with state laws and pharmacy protocols + Manage and verify insurance claims and prior ... OverviewUnited Health Services (UHS) is seeking a dedicated Pharmacist to join our pharmacy team. The Pharmacist will ensure the safe and accurate administration of… more
- Highmark Health (Trenton, NJ)
- …the gap between business needs and the analytical technology team. The Senior Decision Support Consultant will leverage technical, analytical, and business expertise ... of developing technical solutions. The consultant will act as a senior resource within the team, fostering business-to-technical collaboration and providing… more
- Otsuka America Pharmaceutical Inc. (Princeton, NJ)
- …medical needs and nutraceutical products for the maintenance of everyday health. As a Senior Manager, Brand Analytics, you will be part of a high performing team ... into the Director of Brand Analytics and support OAPI's pipeline asset(s). The Senior Manager, Brand Analytics should be able to work independently and effectively,… more
- CVS Health (Monroeville, PA)
- …and partnering with account managers as needed in order to ensure accurate claims processing + Manage the Pharmacy benefit SalesForce.com Specialty Pharmacy ... with heart, each and every day. CVS Health Specialty Pharmacy , a mail service pharmacy in the...area has an opportunity for a full-time Accounts Receivable Senior Coordinator to handle insurance follow up and PBM… more
- BrightSpring Health Services (Nashville, TN)
- …Sr Director's responsibilities include identifying reimbursement issues, ensuring that claims , denials, and appeals are efficiently processed, and resolving ... of month closing procedures. + Develop sustainable processes to bill and adjudicate claims timely to maintain a benchmark cash goal. + Develop denial management… more
- Blue Cross and Blue Shield of Minnesota (Eagan, MN)
- …Blue Cross and Blue Shield of Minnesota Position Title: Healthcare Analyst Senior Location: Hybrid | Eagan, Minnesota Career Area: Data Analytics & Business ... ready to make a difference, join us. The Impact You Will Have The Senior Healthcare Analyst is responsible for contributing to and supporting the strategic needs of… more
- CareFirst (Baltimore, MD)
- …markets risk score methodologies, risk score calculations, enrollment, submissions, medical and pharmacy claims , and provider data. Incumbent is responsible for ... **Resp & Qualifications** **PURPOSE:** The Senior Risk Adjustment Business Operations Analyst assumes a...support as required. We are looking for an experienced professional in the greater Baltimore metropolitan area who is… more
- Blue Cross and Blue Shield of Minnesota (Eagan, MN)
- …driving successful IT development initiatives within the Pharmacy Benefits Manager (PBM) claims space. As a Senior Consultant, you will serve as a critical ... protected characteristic. Blue Cross and Blue Shield of Minnesota Position Title: Senior Business Systems Consultant Location: Hybrid | Eagan, Minnesota Career Area:… more
- JPMorgan Chase (New York, NY)
- …and synthesizing large quantities of health-related data - including medical and pharmacy claims , survey data, and biometrics. You will design creative ... more about our strategy and latest developments, please visit: www.morganhealth.com. As a Senior Associate of Data Science & Research within Morgan Health, you will… more
- HTC Global Services Inc (Berlin, NH)
- …knowledge on the claim adjudication and settlement. This includes both Medical and pharmacy claims . + Understanding of the provider domain and its relationship ... and payer processes. A typical description emphasizes collaboration with Enrollment teams, Claims and provider domains , and IT teams to translate complex healthcare… more