- The Cigna Group (Bloomfield, CT)
- …Desk Audit ( Pharmacy Audit) owns the output of a single work area within Quality Review and Audit and typically manages a team of Quality Assurance/Audit ... job family roles. Responsible for developing and leading Total Quality Management strategies for work team which may include improvement of processes, coaching… more
- 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 ... with a strong focus on member experience. . Coordinates pharmacy reject review and resolution either directly...Part D ( pharmacy ). . Strong knowledge of pharmacy claims processing through retail or mail… more
- Immigration and Customs Enforcement (IN)
- …Medical Payment Authorization Requests (MedPARs) for reimbursable health care services, medical claims review and systems. Liaise regionally and nationally with ... of the primary points of contact for the third-party claims vendor on issues relating to pharmacy ...claim denials and increase the number of paid claims . In Fiscal Year (FY) 2024, IHSC provided direct… more
- Walgreens (Deerfield, IL)
- …viewing presentations). **Preferred Qualifications:** + At least 2 years experience in pharmacy claims processing. We will consider employment of qualified ... High School Diploma/GED and at least 1 year of experience in retail pharmacy , medical claims processing, and/or third party reimbursement. + Required… more
- VNS Health (Manhattan, NY)
- OverviewSupports Pharmacy Services Specialists and Director of Pharmacy Services to perform Quality Improvement interventions, including maintenance of data ... pharmacy outreach. Contacts pharmacies to gather information and to resolve pharmacy benefit coverage and prescription eligibility and claim problems. +… more
- AdventHealth (Apopka, FL)
- …o Expedien Rx Non-Specialty distributive pharmacy operations o Rx Plus Pharmacy Quality Assurance (QA) operations: Tech check Tech where authorized + ... coordinates medication access and adherence, prepares medications for pharmacist review /check, performs claim adjudication and processes customer (patient)… more
- CL Cressler, Inc. (Pittsburgh, PA)
- …through the pharmacy filling system and providing timely and accurate claim adjudication. Typical responsibilities associated with the position are: + Read and ... review prescriptions; enter prescription data into the ...customer service to callers regarding orders + Assists with claim billing and adjudication to third party payers At… more
- UPMC (Pittsburgh, PA)
- UPMC Community Pharmacy is looking for a full time Pharmacy Technician, Intermediate to join their dedicated team at Forbes Outpatient Pharmacy . Qualified ... with the PA Department of Health, The Joint Commission, and State Board of Pharmacy regulations. This role will work 8:00 am to 4:30 pm, Monday through Friday.… more
- Mount Sinai Health System (New York, NY)
- …data from PBM prescription portal for QA report and analyzing + Reviewing pharmacy claims to identify outliers, utilization and prescribing trends + Adhoc ... the NY/NJ region. MSHS, World Trade Center Health Program (WTCHP) seeks a Clinical Pharmacy Manager that reports to Senior Manager, Pharmacy Benefits and works… more
- Prime Therapeutics (Columbus, OH)
- …every decision we make. **Job Posting Title** Dir, Specialty Clinical Solutions/Medical pharmacy exp required- REMOTE **Job Description** + Supports overall Medical ... Pharmacy Product line for health plans through validated program...analytics that improve medical cost savings and provide clinical quality initiatives + Manages current clients in all Medical… more
- ChenMed (Fort Myers, FL)
- …the Pharmacist and adheres to company policies and procedures in regard to pharmacy errors and quality improvement. + Follows all applicable government ... procedures. Employees model and deliver the highest level of quality healthcare while working directly with patients and their...Pharmacy Manager or Pharmacist on duty. + Processes claims for 3rd party reimbursement efficiently and correctly to… more
- ChenMed (Aventura, FL)
- …Pharmacist and adheres to company policies and procedures in regards to pharmacy errors and quality improvement. Follows all applicable government regulations ... procedures. Employees models and delivers the highest level of quality healthcare while working directly with patients and their...workflow and meet/ complete deadlines as assigned by the Pharmacy Manager or Pharmacist on duty. Process claims… more
- The County of Los Angeles (Los Angeles, CA)
- … work of staff. Essential Job Functions Establishes, maintains, and revises unit pharmacy procedures, work standards, and quality control measures within the ... PHARMACY SUPERVISOR I Print (https://www.governmentjobs.com/careers/lacounty/jobs/newprint/3794484) Apply ... and hospital procedures and established professional standards; monitors quality and quantity of production and takes corrective action… more
- CVS Health (Williston, VT)
- …affordable. **Position Summary** This position provides an opportunity for a current Pharmacy Technician with limited availability to continue to play a meaningful ... role in the pharmacy . A Pharmacy Technician Per Diem takes...safe and accurate prescription fulfillment; delivering results while balancing quality and efficiency in all tasks; embracing agility to… more
- Walgreens (Columbus, OH)
- …pharmacist on duty and adheres to Company policies and procedures in relation to pharmacy errors and the Quality Improvement Program. + Strictly adheres to the ... **Job Description:** Our pharmacy technician positions have undergone an exciting transformation,...those to physicians. + Processes (corrects and resubmits) manual claims for third party program prescription services in a… more
- Walgreens (Columbus, OH)
- …pharmacist on duty and adheres to Company policies and procedures in relation to pharmacy errors and the Quality Improvement Program. + Strictly adheres to the ... the pharmacist, under direct supervision, in the practice of pharmacy . Assists the pharmacist in the performance of other...those to physicians. + Processes (corrects and resubmits) manual claims for third party program prescription services in a… more
- Walgreens (Columbus, OH)
- …pharmacist on duty and adheres to Company policies and procedures in relation to pharmacy errors and the Quality Improvement Program. Reviews and complies with ... the pharmacist, under direct supervision, in the practice of pharmacy . Responsible for using pharmacy systems to...those to physicians. + Processes (corrects and resubmits) manual claims for third party program prescription services in a… more
- Walgreens (Portland, OR)
- …pharmacist on duty and adheres to Company policies and procedures in relation to pharmacy errors and the Quality Improvement Program. Strictly adheres to the ... Operations Under the supervision by the pharmacist, assist in the practice of pharmacy , in accordance with state, federal, and company policy. Reviews and complies… more
- Walgreens (Memphis, TN)
- …pharmacist on duty and adheres to Company policies and procedures in relation to pharmacy errors and the Quality Improvement Program. + Strictly adheres to the ... the pharmacist, under direct supervision, in the practice of pharmacy . Assists the pharmacist in the performance of other...those to physicians. + Processes (corrects and resubmits) manual claims for third party program prescription services in a… more
- Walgreens (Twinsburg, OH)
- …pharmacist on duty and adheres to Company policies and procedures in relation to pharmacy errors and the Quality Improvement Program. + Strictly adheres to the ... the pharmacist, under direct supervision, in the practice of pharmacy . Assists the pharmacist in the performance of other...those to physicians. + Processes (corrects and resubmits) manual claims for third party program prescription services in a… more