• Senior Research Advisor, RWD/Clinical…

    The Cigna Group (Raleigh, NC)
    …not limited to the following: + Efficiently query multiple data types (medical and pharmacy claims , EMR, lab, chargemaster) using SQL to identify populations of ... Deep healthcare data (eg, PBM experience, Provider Networks, Billing, Medical and Pharmacy claims ), statistical analysis experience, and an understanding of all… more
    The Cigna Group (02/04/25)
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  • Medicare Pharmacy Coordinator

    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
    Medical Mutual of Ohio (12/20/24)
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  • Healthcare Claims Denials Specialist

    CenterWell (Jefferson City, MO)
    …agencies, and the timely reimbursement of receivables. + Research, resolve, and prepare claims that have not passed the payer edits daily. Determine and initiate ... Analyze each agency's outstanding monthly accounts receivable, and process claims to obtain zero balances. + Clear payment variances,...at the center. As the nation's largest provider of senior -focused primary care, one of the largest providers of… more
    CenterWell (01/17/25)
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  • Pharmacy Technician

    BrightSpring Health Services (Washington, NC)
    … solution providing value beyond medication. PharMerica is the long-term care pharmacy services provider of choice for senior living communities, skilled ... individual to join our team. PharMerica is a non-retail pharmacy that focuses on providing exceptional customer service and...Identifies and resolves issues of denials or follow-up of claims , by maintaining current knowledge of Medicaid claim… more
    BrightSpring Health Services (01/03/25)
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  • Specialty- Pharmacy Technician

    University of Michigan (Ann Arbor, MI)
    …order pharmacy setting. Experience in typing prescriptions and adjudicating claims preferred. + Document all patient interactions in appropriate systems and ... Pharmacy Services, see our annual report at https://www.medicine.umich.edu/dept/ pharmacy / pharmacy -annual-report **Required Qualifications Senior /Intermediate/Associate Level:… more
    University of Michigan (12/11/24)
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  • Associate Director, Pharmacy and Dispensing

    ChenMed (Miami, FL)
    Pharmacy communicates effectively with providers and staff, makes any Dispensing/ Pharmacy -related decisions with discussion with the senior leader, analyzes ... practices, processes, procedures, techniques and methods + Extensive knowledge of pharmacy workflow from prescription to claims submission and authorization… more
    ChenMed (01/07/25)
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  • Senior Medical Director - Sharp Health Plan

    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
    Sharp HealthCare (01/19/25)
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  • Senior Clinical Staff Pharmacist - Revenue…

    UTMB Health (Galveston, TX)
    …practice from the Texas State Board of Pharmacy . **_JOB SUMMARY:_** Senior Clinical Staff Pharmacist provides advanced professional and supervisory skills in ... Senior Clinical Staff Pharmacist - Revenue Integrity and...Requisition # 2500476 **_REQUIRED EDUCATION / EXPERIENCE:_** Doctor of Pharmacy or Bachelor's degree in Pharmacy from… more
    UTMB Health (01/31/25)
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  • Investigator Senior

    Elevance Health (Nashville, TN)
    …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 (01/30/25)
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  • Investigator Senior

    Elevance Health (Tampa, FL)
    …referral, and use of proprietary data and claim systems for review of facility, professional and pharmacy claims . + Responsible for independently identifying ... **Investigator Senior ** **Location:** This position will work a hybrid...to recover corporate and client funds paid on fraudulent claims . **How you will make an impact:** + Claim… more
    Elevance Health (01/28/25)
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  • Senior Scientist, Wellness - Future…

    Haleon (Warren, NJ)
    …building strategic science & technology into new capabilities for R&D. This ** Senior Scientist** helps define the long-term, global Wellness strategy by identifying ... to ensure key science platforms The New Ingredient for Health end points ** Senior Scientist** role focuses on: + New Ingredients & Delivery Technologies + Evidence… more
    Haleon (01/22/25)
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  • Senior Counsel, Employment Law and Benefits…

    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
    Walgreens (11/16/24)
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  • Senior Information Systems Analyst…

    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
    The County of Los Angeles (01/18/25)
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  • Senior Librarian, Acquisitions

    Lee County Board of County Commissioners (Lehigh Acres, FL)
    Senior Librarian, Acquisitions Print (https://www.governmentjobs.com/careers/leecounty/jobs/newprint/4794983) Apply  Senior Librarian, Acquisitions Salary ... develops, and evaluates assigned staff. + Manages ordering, invoicing and receiving, claims , and payments for library resources. + Maintains accurate budget records,… more
    Lee County Board of County Commissioners (01/21/25)
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  • Senior Clinical Operations Analyst

    Dana-Farber Cancer Institute (Boston, MA)
    …access to an extraordinary range of healthcare data (including medical and pharmacy claims , enrollment, EMR, scheduling, billing, referral and laboratory ... Enterprise Data & Analytics (ED&A) team at Dana-Farber is seeking a Senior Clinical Operations Analyst to spearhead high-impact analytics initiatives to inform… more
    Dana-Farber Cancer Institute (01/10/25)
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  • Life Sciences Market Access Senior Manager

    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 ... individuals to expand our network of Market Access focused Senior Managers to help us expand our footprint of...team in development of quantitative and/or qualitative analysis (eg, claims data analysis, market research data) to drive meaningful… more
    Deloitte (01/12/25)
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  • Business Intelligence Analyst (Business…

    Elevance Health (Independence, OH)
    **Business Intelligence Analyst (Business Information Analyst Senior )** **Location:** This position will work a hybrid model (remote and in office 1 - 2 days per ... Indianapolis, IN. The **Business Intelligence Analyst (Business Information Analyst Senior )** is responsible for analyzing, reporting, and developing recommendations… more
    Elevance Health (02/04/25)
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  • Senior Investigator, Special Investigative…

    CVS Health (Trenton, NJ)
    …from home anywhere in the United States. We are seeking an experienced Senior Healthcare Fraud Investigator to join our Special Investigations Unit (Aetna SIU). In ... abuse. + Conduct Investigations to prevent payment of suspect or fraudulent claims submitted by insured's, providers, claimants, and customers. + Researches and… more
    CVS Health (01/18/25)
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  • Senior Manager, Market Access Insights…

    AbbVie (Mettawa, IL)
    …payer formulary access that maximize net sales for assigned brands. Identify through claims analysis, market dynamics that shape brand demand and build models to ... areas of functional scope include: + Leading the development of GPO, Specialty Pharmacy , Health Plan and PBM contracting strategies for launch brands across payer… more
    AbbVie (01/28/25)
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  • Plan Administration Analyst

    BrightSpring Health Services (Louisville, KY)
    …to work effectively with internal customers Microsoft office products + Knowledge of claims processing system or pharmacy practice system desired + Strong ... solution providing value beyond medication. PharMerica is the long-term care pharmacy services provider of choice for senior living communities, skilled… more
    BrightSpring Health Services (01/31/25)
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