- CVS Health (Scottsdale, AZ)
- …is to incorporate your proven expertise in Network enrollment documentation/processes, pharmacy audit financial recoveries and other associated activities (ie, ... of strategic response development based on in-depth experience regarding specific pharmacy audit , contract, credentialing and financial recovery questions and… more
- Molina Healthcare (Albany, NY)
- …or related compliance functions-hands-on with CMS CTM portal, SLA tracking, and program audits. * Deep knowledge of Medicare regulations affecting complaints, ... keep complaint data synchronized across appeals & grievances, enrollment, claims, pharmacy , and quality functions. You surface systemic issues, steer partners toward… more
- Adecco US, Inc. (Monroeville, PA)
- …healthcare career? **Adecco Health Care and Life Sciences** is hiring for a ** Pharmacy Benefits Call Center Representative** in **Monroeville, PA** . This is a ... Experience and Skills:** + 1 year **of medical billing experience** ( Medicare experience preferred). + Strong computer skills, including proficiency in **Microsoft… more
- Walmart (Orlando, FL)
- …Medicare orders to ensure compliance; and interpreting and documenting Medicare audit documents. + Ensures fulfillment of pharmacy prescriptions in a Home ... ** **What you'll do ** We are hiring Certified Pharmacy Technicians for our Orlando, Florida location. The candidate...a safe and clean work environment. + Complies with Medicare and Medicaid policies and procedures by implementing and… more
- Molina Healthcare (Savannah, GA)
- …Ambulatory Care Residency **Preferred Experience** Experience with Medicaid and/or Medicare programs . **Preferred License, Certification, Association** * Board ... responsible for creating, operating, and monitoring Molina Health Plan's pharmacy benefit programs in accordance with all...Program . * Assists in coordination of care for pharmacy related issues between members, providers and other members… more
- UPMC (Pittsburgh, PA)
- …using programs such as: copay assistance, pharmaceutical manufacturer assistance programs , foundation assistance and UPMC program . Promote quality and ... follow proper cash handling policies and procedure + General: Audit and maintain accurate records for controlled substances. Assure...school diploma or equivalent OR Completion of an accredited pharmacy technician program AND one of the… more
- UPMC (Pittsburgh, PA)
- …using programs such as: copay assistance, pharmaceutical manufacturer assistance programs , foundation assistance and UPMC program . Promote quality and ... follow proper cash handling policies and procedure + General: Audit and maintain accurate records for controlled substances. Assure...diploma or equivalent OR + Completion of an accredited pharmacy technician program AND one of the… more
- Dartmouth Health (Lebanon, NH)
- …Bonus External candidates only Dartmouth Hitchcock Medical Center in Lebanon, NH seeks a Pharmacy Technician to join our Inpatient Pharmacy team. Our Pharmacy ... an Academic Medical Center which prides itself on supporting education and training. Pharmacy Technicians will routinely engage with the training and support of new… more
- Dartmouth Health (Bedford, NH)
- …on a day to day basis. This job builds on the responsibilities of a Pharmacy Technician Certified III. This is a Full Time, 40hr per week, benefitted position. ... Tuition Reimbursement:Up to $3,000 per year. Dental Vision \#CPT, # Pharmacy Technician, #Dartmouth-Hitchcock Pharmacy Responsibilities * Answers Phones.… more
- Walgreens (Deerfield, IL)
- …etc). + Acts as a liaison and partners with Provider Enrollment, Accounting, Contracting, Medicare B Operations, and Third Party Audit teams for store team ... Commercial, Government, 340B and Walgreens Direct Bill contracts. Enters plans into pharmacy system and provides issue resolution and support for the stores.… more
- CenterWell (Savannah, GA)
- …of inquiries, requests, and complaints from patients + Ongoing chart review / audit of clinical staff to ensure quality care and identifying opportunities for ... education/coaching + Identifying trends and areas of opportunity in pharmacy utilization ( pharmacy management) to impact Part D per Member per Month (PMPM) costs… more
- Cambridge Health Alliance (Cambridge, MA)
- …regulatory and policy changes affecting PACE and HPO. * Lead internal and external audit preparation and response, including Medicare Part D and Enrollment Data ... 40.00 **Union Name:** Non Union **About CHA PACE** Cambridge Health Alliance's ** Program of All-Inclusive Care for the Elderly (PACE)** is a nationally recognized… more
- AbbVie (North Chicago, IL)
- …existing requirements. Appear and present before state boards as required. Comply with pharmacy audit and inspection requests by both internal and external ... to function as a licensed pharmacist in charge (PIC), engaged in the practice of pharmacy for Pharmacy Solutions. The PIC is responsible to ensure the daily… more
- Corewell Health (Grand Rapids, MI)
- … program tactics. Manage the vendors that are hired to perform Universal program review and audit functions for Priority Health. Oversee all activities ... for management of all aspects of the Payment Integrity Program with specific expertise in healthcare payment and reimbursement....a managed care payer + Experience working with government programs including Medicare , Medicaid and FEHB +… more
- Heritage Ministries (Conneautville, PA)
- …insurance + Paid training opportunities + Education Assistance plans + Employee pharmacy program + Special employee recognition and giveaways Qualifications: + ... responsible for the coordination and completion of necessary functions to assure Medicare and other payer's requirements are maintained in regards to clinical… more
- Corewell Health (Grand Rapids, MI)
- … program requirements, providing feedback and recommendations to ensure compliance and program integrity + Interpret audit results and assist health plan ... experience Required + 7 years of relevant experience Experience working with government programs including Medicare , Medicaid and FEHB Required + 5 years of… more
- University of Rochester (Rochester, NY)
- …drugs (HazD) in compliance with USP 800 standards, Centers for Medicare and Medicaid Services┐ Conditions of Participation, Department of Health regulations, ... state, and all sites remain in a ready for audit /inspection state. Serves as the chair for the Hazardous...development and implementation of a quality assurance and control program that collects and reports relevant data for adherence… more
- University of Colorado (Aurora, CO)
- …for reporting to leadership and the board. + Coordinates and submits annual Medicare and Medicaid cost reports, quarterly audit and reporting requirements, and ... maintains policies and procedures for the sliding fee discount program . + Serves as the approver of procurement card...data to support all service lines. + Supports 340B Pharmacy compliance by providing fiscal analysis and participating in… more
- Actalent (Roseville, MN)
- …Skills & Qualifications + Experience with fulfillment, supervision, MTM, inventory control, Medicare , and retail pharmacy . Work Environment Work in a closed ... assessments and verify medication appropriateness before fulfillment. + Enter and audit patient demographics, insurance details, and prescription information in … more
- STG International (Milledgeville, GA)
- …Resident Assessment Instrument (RAI) process. + Assist to develop a dementia care program involving an interdisciplinary approach with a holistic focus on the needs ... Coordinate Pre-certification sand recertification in accordance with facility policies for Medicare Advantage and + commercial insurance payers. + Interpret the… more