- Prime Therapeutics (Annapolis, MD)
- …that. It fuels our passion and drives every decision we make. **Job Posting Title** Senior Claims Operations Business Analyst - Remote **Job Description ... Summary** Serves as liaison between departmental team business owners, end users, IT, Claims and...Medicare, requires 3+ years of experience working in Medicare Operations . **Work Experience** Work Experience - Required: Business… more
- Humana (Annapolis, MD)
- …caring community and help us put health first** The Senior Pharmacy Claims Operations Professional oversees the business processes and ensures accuracy ... of sale transition adjudicated claims logic. The Senior Pharmacy Claims Operations Professional...**Responsibilities** The Senior Pharmacy Claims Operations Professional analyzes, monitors and enhances business … more
- HealthEdge Software Inc (Annapolis, MD)
- …integrated solutions suite includes the industry's leading, digital, next-generation claims administration processing system, business intelligence, integration ... **Overview** ** Senior Manager, Product Operation** **Position Overview:** We areseekinga...our product teams to solve hard problems-customer problems and business problems-in ways that our customers love and that… more
- Elevance Health (Hanover, MD)
- **Clinical Provider Auditor Senior - Maryland Behavioral Health** **Supports Payment Integrity & Behavioral Health** _Location: This position will work a hybrid ... analytics to improve the delivery of care. The **Clinical Provider Auditor Senior ** is responsible for identifying issues and/or entities that may pose potential… more
- Zurich NA (Annapolis, MD)
- Senior US International Reverse Flow Underwriter 117849 Zurich is seeking a senior level US International Reverse Flow Underwriter to join our International ... Operations team in our Schaumburg, IL North America Headquarters....provide US underwriting support for incoming received country (RC) business from non-US producing countries. In this model the… more
- Evolent Health (Annapolis, MD)
- …products. You will collaborate with cross-functional teams, including solution strategy, business operations , engineering, quality assurance, and IT, to ensure ... You'll Be Doing:** **What You'll Be Doing:** As a Senior Product Analyst, you will have the opportunity to...market, and the customers. They collaborate with implementation teams, business operations , engineering, and growth teams to… more
- Prime Therapeutics (Annapolis, MD)
- …across the organization to validate regulatory requirements are met and that business operations are aligned with expectations of applicable regulatory guidance ... guidance and regulatory issues that impact Prime's compliance programs or business operations ; document requirements or disciplinary actions and escalate… more
- CareFirst (Columbia, MD)
- …relate to risk mitigation and effective external/internal controls for CareFirst Business Operations . + Initiates claim adjustments, court ordered restitution, ... execute investigative plans that may include performance of audits of financial business records, provider and subscriber medical data, claims , systems? reports,… more
- Fujifilm (Annapolis, MD)
- …please visit_ _healthcaresolutions-us.fujifilm.com_ _._ **External US** **Job Title:** ** Senior Compliance Specialist** **Job purpose** The accomplished Senior ... Compliance Specialist will support FUJIFILM's Corporate compliance program operations to ensure high ethical standards are observed and compliance program is… more
- Prime Therapeutics (Annapolis, MD)
- …file maintenance of enrollment, assessment and dis-enrollment documentation for strategic business unit (SBU) operations . **Job Description** + Effectively ... and drives every decision we make. **Job Posting Title** Senior Enrollment Specialist **Job Description Summary** This position is...supports Magellan's SBU program operations ensuring that data is entered accurately and timely… more
- Cardinal Health (Annapolis, MD)
- …colleagues as a coveted member of the Product Experience organization. As a Senior Product Experience Designer, you will define, lead, and implement the analytics ... their practices' financial performance. These products help monitor drug utilization, claims payment and denials, reimbursement trends, margins, and provide insights… more
- Cardinal Health (Annapolis, MD)
- …of data to create innovative solutions that improve patient outcomes, streamline operations , and enhance the overall healthcare experience. We are seeking a highly ... Difference: Contribute to cutting-edge solutions that improve patient care, enhance healthcare operations , and drive positive change in the industry. + Work with a… more
- CVS Health (Annapolis, MD)
- …abuse. + Conduct Investigations to prevent payment of suspect or fraudulent claims submitted by insured's, providers, claimants and customers. + Researches and ... tools, social media and internet research. + Ability to Travel for Business purposes. **Preferred Qualifications** + Certified Professional Coder (CPC), AHFI, CFE +… more
- Humana (Annapolis, MD)
- …remote In this lead role you'll have the opportunity to analyze complex business and clinical issues leveraging healthcare and operational data to support healthcare ... collaboratively with clinicians, data scientists, actuaries, subject matter experts, and business owners across Humana to drive solutions forward. In this role… more
- Total Civil Construction & Engineering, LLC (Lanham, MD)
- …support to the Operations department and works closely with the Sr. Operations Managers, Regional Claims Managers, to enforce company safety, health and ... company safety & loss control policies. + Provide leadership and direction to Business Units in their area of responsibility in implementing cultural changes in… more
- Humana (Annapolis, MD)
- …to evaluate claims data to drive deeper insights into the business and identify opportunities + Coordinate Value-Based impacts across Humana and CenterWell ... Experience in managing data to support and influence decisions on day-to-day operations , strategic planning, and specific business performance issues. + Advanced… more
- Walgreens (Edgewater, MD)
- …customers and developing strong patient relationships. Pharmacy is the core of our business , and our pharmacy technicians enjoy all the tools and support - including ... until satisfied, etc.). + Develops strong relationships with most valuable customers. ** Operations ** + Under the supervision by the pharmacist, assist in the… more
- Cardinal Health (Annapolis, MD)
- …and Patient Support (APS) is responsible for the tactical execution of operations of assigned program(s) for contracted client manufacturer(s). This individual will ... understanding of healthcare reimbursement (managed care and specialty pharmacy operations ). In addition to stewarding relationships with the pharmaceutical… more
- Prime Therapeutics (Annapolis, MD)
- …(can include Government Programs, Compliance, Healthcare Reform, Legal, Networks, Clinical Operations , Paper Claims , Member Materials, IT, etc.) to ensure ... **Job Posting Title** Regulatory Analyst Sr - Remote **Job Description** The Senior Regulatory Analyst is responsible for leading portions of departmental regulatory… more
- Target (Upper Marlboro, MD)
- …worldwide. There's so much good work to be done, from Distribution Center Operations , where process and problem solving drive our results; Quality Management, which ... our people, process and technology investments to support an ever evolving business . As an Engineering & Facilities Administrative Assistant, you'll work on a… more