• Senior Pharmacy Claims

    Humana (Richmond, VA)
    …level by driving real impact and shaping the future of claims management? As a Senior Pharmacy Claims Professional , you will play a pivotal role in ... and take the lead on building solutions that make a difference! The Senior Pharmacy Claims Professional analyzes and answers inquiries regarding… more
    Humana (09/18/24)
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  • Senior Transition Pharmacy

    Humana (Richmond, VA)
    **Become a part of our caring community and help us put health first** The Senior Pharmacy Claims Professional adjudicates pharmacy claims and ... process pharmacy claims for payment. The Senior Pharmacy Claims Professional work assignments involve moderately complex to complex issues where… more
    Humana (09/06/24)
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  • Account Service Manager Sr - Pharmacy

    Elevance Health (Richmond, VA)
    **Account Service Manager Sr - Pharmacy Account Management** **Location:** This position will work a hybrid model (remote and office). The ideal candidate must live ... plan design, researching and resolving phone and written inquiries, resolving claims , benefit and enrollment issues. + Presents monthly, ad hoc, mid-year,… more
    Elevance Health (09/17/24)
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  • Investigator Senior

    Elevance Health (Richmond, VA)
    …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 (09/20/24)
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  • Senior Economist

    Humana (Richmond, VA)
    …Benefit Manager, Pharmacy , or Healthcare data, in particular drug utilization, claims , costs and forecasting + Experience with techniques that can improve our ... help us put health first** Humana is seeking a Senior Economist to lead the development and management of...in applying econometric techniques to real-world problems, with either professional work experience or publication history + Ability to… more
    Humana (09/21/24)
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  • Investigator II - Carelon Payment Integrity

    Elevance Health (Richmond, VA)
    …referral, and use of proprietary data and claim systems for review of facility, professional and pharmacy claims . + Responsible for identifying and ... healthcare fraud in order to recover corporate and client funds paid on fraudulent claims . **How you will make an impact:** + Claim reviews for appropriate coding,… more
    Elevance Health (09/20/24)
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  • Investigator II

    Elevance Health (Richmond, VA)
    …referral, and use of proprietary data and claim systems for review of facility, professional and pharmacy claims . + Responsible for identifying and ... healthcare fraud in order to recover corporate and client funds paid on fraudulent claims . **How you will make an impact:** + Claim reviews for appropriate coding,… more
    Elevance Health (09/19/24)
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