- Merck & Co. (North Wales, PA)
- Job DescriptionResponsibilities:Utilize big data to analyze the safety and efficacy claims of potential medical breakthroughs.Review the quality and reliability of ... including clinical development and safety evaluation.Collaborate with statistics and other project stakeholders in ensuring project plans are executed… more
- Humana (Trenton, NJ)
- …independent determination of the appropriate courses of action. **Where you Come In** As a Claims Process Organization Project Manager II you will manage ... caring community and help us put health first** The Project Manager II manages all aspects of a ... + Communicate with other operational areas in the organization to secure specialized resources and contributions for the… more
- AIG (Croydon, PA)
- …Operations. This varied role will have responsibility for implementation of claims strategic initiatives, delivering service excellence through process ... initiatives and projects in the UK leading projects independently and work closely with Claims Operations Analyst in delivering project plans. + Work in close… more
- Humana (Trenton, NJ)
- …career to the next level by driving real impact and shaping the future of claims management? As a Senior Pharmacy Claims Professional, you will play a pivotal ... in resolving outstanding balances related to claim reversals, all while leading process improvements and influencing departmental strategies. This is your chance to… more
- CVS Health (Blue Bell, PA)
- …accurate payment of provider contracts through **Health Rules Payor (HRP** ) a claims processing platform. As part of the Network Contract Validation team, you will ... contract setup against contract intent and evaluate the pricing performance of claims . Accurate provider pricing configuration is critical to claims … more
- American Heart Association (Philadelphia, PA)
- …such as code book, Case Report Forms, Surveys, EHR queries and other data project documentation process . + Develop and implement guidelines to manage data ... for you to be able to integrate data from different sources (clinical, claims , patient-reported survey data, food vendors). The Database Designer is responsible for… more
- Guardian Life (Trenton, NJ)
- **Job Posting Title** **Team Leader, Absence Claims Management** **Job Description** The **Team Leader, Absence Claims Management** is responsible for leading a ... Managers to get results within their team and the organization . The Team Leader will serve as a primary...action plans for improvement. + Review processes/reports regularly for process improvement opportunities. + Own relationship with client and… more
- Norstella (Trenton, NJ)
- …Now, Citeline is proud to be a part of Norstella, an organization that consists of market-leading pharmaceutical solutions providers united under one goal: ... to improve patient access to life-saving therapies. Within this organization , Citeline plays a key role in helping clients connect the dots from pipeline to patient.… more
- AON (Philadelphia, PA)
- …better to protect and enrich the lives of people around the world. As an organization , we are united through trust as one inclusive, diverse team, and we are ... business, cultivating relationships with senior-most client decision-makers in the client organization as well as with day-to-day client contacts. + Ensures overall… more
- Deloitte (Philadelphia, PA)
- …the power of hybrid services and products, and unlocking the power of Process Bionics to deliver sustainable and impactful solutions to our clients. We advise, ... relevant processes and technologies for their industry-and apply them with a process and mindset that tailors transformational change to their specific … more
- Deloitte (Philadelphia, PA)
- …the power of hybrid services and products, and unlocking the power of Process Bionics to deliver sustainable and impactful solutions to our clients. We advise, ... relevant processes and technologies for their industry-and apply them with a process and mindset that tailors transformational change to their specific … more
- The Cigna Group (Philadelphia, PA)
- …of the various products and services to support Cigna's pharmaceutical and claims operations life cycle. This includes leading sourcing projects of various sizes ... and maintenance for activities around identifying a supplier, managing the competitive process and recommending a supplier that best meets the business objectives.… more
- Emerson (Trenton, NJ)
- …Engineer to oversee and manage projects related to feeding systems in our organization . The successful candidate will coordinate and lead projects from conception to ... proposal with the sales team, making adjustments as necessary. Overall Project Responsibility: + Assume end-to-end project responsibility, ensuring consistency… more
- Elevance Health (Wilmington, DE)
- …communicates requirements to the programming group. + Conduct review of administrative claims data and statistical output to ensure the superior quality of research ... study deliverables and presentation of such and facilitates collaboration among project team members towards their development. **Minimum Requirements:** Requires a… more
- Deloitte (Philadelphia, PA)
- …the power of hybrid services and products, and unlocking the power of Process Bionics to deliver sustainable and impactful solutions to our clients. We advise, ... relevant processes and technologies for their industry-and apply them with a process and mindset that tailors transformational change to their specific … more
- Deloitte (Philadelphia, PA)
- …the power of hybrid services and products, and unlocking the power of Process Bionics to deliver sustainable and impactful solutions to our clients. We advise, ... relevant processes and technologies for their industry-and apply them with a process and mindset that tailors transformational change to their specific … more
- Prime Therapeutics (Trenton, NJ)
- …Description** + Performs exploratory data analysis and data mining of healthcare claims and authorizations data. + Designs, documents, develops and rolls out ... reports that give a detailed description of the current project 's progress and indicates time devoted to each task...in easily understandable format for varying levels of the organization . **Responsibilities** + 3+ years of transact-SQL (MS SQL… more
- Merck (North Wales, PA)
- …**Responsibilities:** + Utilize big data to analyze the safety and efficacy claims of potential medical breakthroughs. + Review the quality and reliability of ... clinical development and safety evaluation. + Collaborate with statistics and other project stakeholders in ensuring project plans are executed efficiently with… more
- The Cigna Group (Philadelphia, PA)
- …of MOS. Responsibilities include but are not limited to reimbursement process and policies, contract solutions, provider relations, data load/management and network ... network knowledge to mentor the team, identify trends as well as facilitate process improvements to positively impact participant quality of care, access as well as… more
- IQVIA (Philadelphia, PA)
- …insurance and adjudication processes + Understanding pharmacy and medical co-pay claims processing + Proficient in cross training in various departments, knowledge ... pharmaceutical industry, including the applications for IQVIA data) + Change management/ process analysis skills. + Strong communication skills, including ability to… more
