- Molina Healthcare (New York, NY)
- **JOB DESCRIPTION** **Job Summary** Molina Pharmacy Services/Management staff work to ensure that Molina members, providers, and pharmacies have access to all ... These jobs are responsible for creating, operating, and monitoring Molina Health Plan's pharmacy benefit programs in accordance with all federal and state laws. Jobs… more
- Mount Sinai Health System (New York, NY)
- …the WTCH clinic population. The Clinical Pharmacy Manager will act as the pharmacy representative for the WTCHP clinic(s) in coordination with other MSHS ... prescription portal for QA report and analyzing + Reviewing pharmacy claims to identify outliers, utilization and...supervisor, subject to reasonable accommodation . + Serve as pharmacy representative on behalf of MSHP as… more
- Prime Therapeutics (Trenton, NJ)
- …/ scrum leading experience + PBM experience or experience working with medical claims , pharmacy claims , healthcare and/or benefits data + Experience ... partnerships with various levels of leadership within the organization, acting as a representative of the broader Reporting and Analytics team + Coach and provide… more
- VNS Health (Manhattan, NY)
- …to Fraud, Waste, and Abuse of Medicare/Medicaid services. + Collaborates with pharmacy services to review PBM activities and denial of prior authorizations, ... of care and member/provider satisfaction. + Acts as a representative of the VNS Health Plans and an advocate...physicians regarding medical policies, utilization management, gaps in care, claims editing, use of resources and quality. + Performs… more