- Humana (Annapolis, MD)
- …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 (Washington, DC)
- **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 (Washington, DC)
- …data analysis & problem-solving skills **Preferred Qualifications** + Previous experience with pharmacy claims + Previous experience performing pharmacy data ... us put health first** Be a part of our Pharmacy Clinical Programs Overutilization Review and Monitoring team. Provide...at the center. As the nation's largest provider of senior -focused primary care, one of the largest providers of… more
- Humana (Washington, DC)
- …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
- Elevance Health (Washington, DC)
- …referral, and use of proprietary data and claim systems for review of facility, professional and pharmacy claims . + Responsible for independently identifying ... **Investigator Senior ** **Supports the Payment Integrity line of business**...to recover corporate and client funds paid on fraudulent claims . **How will you make an impact:** + Claim… more
- Humana (Washington, DC)
- …informaticists to define various clinical concepts and extract clinical information from medical, pharmacy , and lab claims for analytics and modeling purposes + ... + Healthcare or managed care working experience + Experience working with medical, pharmacy , lab claims + Experience working with big data and using… more
- VHC Health (Arlington, 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 (Washington, DC)
- 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
- WTW (Arlington, VA)
- …specialty consulting services including clinical/health management program design, pharmacy solutions, disability/absence management strategies and claims ... audit services. Product based solutions such as our pharmacy purchasing coalition round out our broad-based suite of...data and create client deliverables drafts for review by senior colleagues. **Love your work.** You will partner with… more
- RELX INC (Alexandria, VA)
- Senior Director-Product ManagementAre you a thought leader and innovator seeking a new opportunity? Would you like to lead a team to solve complex business problems? ... Team leads the strategy and development of Healthcare solutions, leveraging provider, claims , and consumer data to provide insights for Healthcare Payer, Provider,… more
- CenterWell (Silver Spring, MD)
- …team at the branch to ensure other billing requirements are satisfied to release claims timely. + Adhere to and participate in Agency's mandatory HIPAA / Privacy ... Guidelines. + Managing all incoming telephone calls in a professional manner including: + Screen and route calls to...at the center. As the nation's largest provider of senior -focused primary care, one of the largest providers of… more