- Humana (Columbus, OH)
- …of our caring community and help us put health first** The Senior Pharmacy Claims Operations Professional oversees the business processes and ensures ... sale transition adjudicated claims logic. The Senior Pharmacy Claims Operations Professional work assignments involve moderately complex to complex… more
- Deloitte (Sacramento, CA)
- …terms) with PBMS + Experience performing analytical analysis of medical & pharmacy claims , including understanding financial impact of network changes, design ... interested in working in a dynamic environment that offers opportunities for professional growth and new responsibilities? Are you interested in helping clients… 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 ... oversight process questions. . Performs other duties as assigned. ** Senior Medicare Pharmacy Coordinator** Working under limited...Part D ( pharmacy ). . Strong knowledge of pharmacy claims processing through retail or mail… more
- CenterWell (Topeka, KS)
- …community and help us put health first** As an **Accounts Receivable Specialist/Healthcare Claims Denials Specialist** , you will: + Ensure the coordination of claim ... timely reimbursement of receivables. + Research, resolve, and prepare claims that have not passed the payer edits daily....at the center. As the nation's largest provider of senior -focused primary care, one of the largest providers of… more
- CenterWell (Columbus, OH)
- …Performs computations. Typically works on semi-routine assignments. Job Description The Pharmacy Claims Representative 2 analyzes and answers inquiries regarding ... pharmacy claims adjudication, including method of payment, co-pay or deductible...at the center. As the nation's largest provider of senior -focused primary care, one of the largest providers of… more
- BrightSpring Health Services (Wilkes Barre, PA)
- … solution providing value beyond medication. PharMerica is the long-term care pharmacy services provider of choice for senior living communities, skilled ... focus on fulfilling the pharmaceutical needs of our long-term care and senior living clients. We offer a non-retail pharmacyenvironment. Our organization is inhigh… more
- Mount Sinai Health System (New York, NY)
- …and a top-ranked academic medical center. We are transforming our business to focus on pharmacy health - our goal is to keep entire communities healthy and out of ... the hospital. The Ambulatory Pharmacy is the team driving this transformation within Mount...within MSHS team + Opportunity to work directly with senior leaders from across the Mount Sinai Health System… more
- BrightSpring Health Services (Washington, NC)
- … solution providing value beyond medication. PharMerica is the long-term care pharmacy services provider of choice for senior living communities, skilled ... individual to join our team. PharMerica is a non-retail pharmacy that focuses on providing exceptional customer service and...Identifies and resolves issues of denials or follow-up of claims , by maintaining current knowledge of Medicaid claim… more
- University of Michigan (Ann Arbor, MI)
- …order pharmacy setting. Experience in typing prescriptions and adjudicating claims preferred. + Document all patient interactions in appropriate systems and ... Pharmacy Services, see our annual report at https://www.medicine.umich.edu/dept/ pharmacy / pharmacy -annual-report **Required Qualifications Senior /Intermediate/Associate Level:… more
- BrightSpring Health Services (Washington, NC)
- … solution providing value beyond medication. PharMerica is the long-term care pharmacy services provider of choice for senior living communities, skilled ... Our Company PharMerica Overview Provides a variety of pharmacy technician, data entry , billing and IV...Identifies and resolves issues of denials or follow-up of claims , by maintaining current knowledge of Medicaid claim… more
- Humana (Columbus, OH)
- …frameworks to maximize ability of limited resources to achieve growth. **The Senior Strategy Advancement Professional ** will support initiatives to develop and ... assess, and translate state requirements into actionable go-to-market strategy. The Senior Strategy Advancement Professional will consult with growth partners… more
- Sharp HealthCare (San Diego, CA)
- …the position, and employer business practices. **What You Will Do** This Senior Medical Director position provides critical management and oversight for Sharp Health ... of our members related to their medical, behavioral health and pharmacy needs. This position also provides the physician cohesive collaboration necessary… more
- The Cigna Group (Bloomfield, CT)
- …Analytics Senior Advisor will lead development of data analyses utilizing pharmacy claims , clinical outcomes, and Stars quality measures to make ... **Summary** The Part D Stars Business Analytics Senior Advisor will be responsible for leading the...Measures + Extensive knowledge of and experience working with pharmacy claims data, customer eligibility data, and… more
- Elevance Health (St. Louis, MO)
- …referral, and use of proprietary data and claim systems for review of facility, professional and pharmacy claims . + Responsible for independently identifying ... **Investigator Senior ** _This position will work a hybrid model...to recover corporate and client funds paid on fraudulent claims . **How you will make an impact:** + Claim… more
- Walgreens (Deerfield, IL)
- **Job Description:** **Job Summary** As Senior Counsel, Employment Law and Benefits, you will play an integral role in helping a highly complex, fast paced ... varying levels on wage and hour matters, workplace accommodations, protected leave, claims of harassment, discrimination, paid sick leave and benefits support and… more
- The County of Los Angeles (Los Angeles, CA)
- SENIOR INFORMATION SYSTEMS ANALYST (Electronic Health Record) Print (https://www.governmentjobs.com/careers/lacounty/jobs/newprint/3124187) Apply SENIOR ... applications; or ancillary services applications such as lab, radiology, and pharmacy . Provides technical leadership in IT strategic planning, business automation… more
- VHC Health (Alexandria, VA)
- Senior Epic Resolute Hospital Billing Analyst II Job Description Purpose & Scope: This position is responsible for leading, coordinating, and supporting the ... of the Epic hospital billing module installation. Responsibilities include serving as the senior point of contact with clinical areas that are the primary users of… more
- Deloitte (San Francisco, CA)
- Life Sciences Market Access Senior Manager An evolving customer and regulatory landscape, mounting pipeline of next-gen assets and portfolio pressures, and ... + Lead team in development of quantitative and/or qualitative analysis (eg, claims data analysis, market research data) to drive meaningful insights for our… more
- AbbVie (Mettawa, IL)
- …of contracting and other access strategies. MAJOR RESPONSIBILITIES We are seeking a dynamic professional to join our team as a Manager or Senior Manager. The ... that maximize net sales for assigned brands. Identify through data science and claims analysis, market dynamics that shape brand demand and build models to portray… more
- Ankura (NY)
- …medical services . Familiar with the revenue cycle process and facility and professional claims . Demonstrates excellent communication skills, both written and ... disputes involving payers and providers, as well as in matters involving False Claims Act, Anti-kickback, Stark, and FDA disputes and investigations. We work with… more