- UPMC (Pittsburgh, PA)
- UPMC Health Plan has an exciting opportunity for a Senior Clinical Pharmacy Specialist in the Pharmacy Services department. This is primarily a ... with clinical management of the designated line of business (Commercial, Exchange, Medicare , Medicaid, Exchange, and/or CHIP) from a pharmacy formulary and… more
- Marshfield Clinic (Marshfield, WI)
- …support the most exciting missions in the world!** **Job Title:** Clinical Pharmacy Specialist **Cost Center:** 301641296 Pharmacy -Admin **Scheduled Weekly ... shifts (United States of America) **Job Description:** **JOB SUMMARY** The Clinical Pharmacy Specialist works with physicians, staff, and committees to optimize… more
- Avera (Sioux Falls, SD)
- …for a $4,000 sign-on bonus! Will also have responsibilities to Avera Specialty Pharmacy to ensure optimized patient experience. **You Belong at Avera** **Be part of ... Work where you matter.** **A Brief Overview** Works proactively with pharmacy patients to provide comprehensive financial planning and financial advocacy.… more
- Sanford Health (Fargo, ND)
- …**Job Summary** The Ambulatory Care Pharmacist at Sanford Health delivers innovative and high- quality care as a part of our healthcare team. The pharmacist provide ... well as nursing and other support staff. o Utilize pharmacy consults and collaborative practice agreements to assist providers...the clinic support staff. o Conduct Office Visits or Medicare Annual Wellness Visits at assigned clinic(s) o Assist… more
- Centene Corporation (Tallahassee, FL)
- …to updates. + Learn every different department, billing, enrollment, sales, pharmacy , complaints, CS quality , Pre-enrollment calls, and marketing issues. ... and sometimes helping to create the new call flows/tools. **Desired skills:** + ** Pharmacy ** : Understanding Medicare Part D, particularly PDP is a plus.… more
- Heritage Ministries (Greenhurst, NY)
- Job Description The Facility Financial Specialist is responsible for welcoming and directing new residents and their families on the day of admission. He/she is ... face sheet, and the primary insurance coverage (other than Medicare ). Verifies the Medicare benefit and coverage...copies of all forms generated by the Facility Financial Specialist to the assigned social worker and business office.… more
- Polaris Pharmacy Services, LLC (Des Plaines, IL)
- Prior Authorization Specialist Job Details Job Location Polaris Pharmacy Services of Illinois, LLC - Des Plaines, IL Salary Range $20.00 - $23.00 Hourly Job ... Category Pharmaceutical Description WHO WE ARE At Polaris Pharmacy Services, we're more than a pharmacy ...services. As industry leaders, we're raising the bar for quality and coordination across all sites of care, ensuring… more
- Polaris Pharmacy Services, LLC (Fort Lauderdale, FL)
- Billing Specialist Job Details Job Location Polaris Pharmacy Services of Ft Lauderdale - Ft. Lauderdale, FL Position Type Full Time Job Category Admin - Clerical ... Description WHO WE ARE At Polaris Pharmacy Services, we're more than a pharmacy ...services. As industry leaders, we're raising the bar for quality and coordination across all sites of care, ensuring… more
- Polaris Pharmacy Services, LLC (Fort Lauderdale, FL)
- Collections Specialist Job Details Job Location Polaris Pharmacy Services of Ft Lauderdale - Ft. Lauderdale, FL Position Type Full Time Job Category ... Pharmaceutical Description WHO WE ARE At Polaris Pharmacy Services, we're more than a pharmacy ...services. As industry leaders, we're raising the bar for quality and coordination across all sites of care, ensuring… more
- Deschutes County (Bend, OR)
- Behavioral Health Specialist II, Civil Commitment Investigator/Monitor Print (https://www.governmentjobs.com/careers/deschutes/jobs/newprint/5158351) Apply ... Behavioral Health Specialist II, Civil Commitment Investigator/Monitor Salary $6,004.15 - $8,448.45...outdoor recreation capital of Oregon. We enjoy a renowned quality of life, with big-city opportunities and small-town neighborhoods.… more
- Deschutes County (Bend, OR)
- Behavioral Health Specialist II - Child, Family & Young Adult Print (https://www.governmentjobs.com/careers/deschutes/jobs/newprint/5052532) Apply Behavioral ... Health Specialist II - Child, Family & Young Adult Salary...outdoor recreation capital of Oregon. We enjoy a renowned quality of life, with big-city opportunities and small-town neighborhoods.… more
- Prime Therapeutics (Madison, WI)
- …build the future of pharmacy with us. **Job Posting Title** Client Audit Specialist - Remote **Job Description** As a member of the Client Audit Management (CAM) ... team, the Client Audit Specialist is accountable for independently, or in collaboration with...recommendations to prevent delays or future findings + Perform quality reviews and analysis of audit deliverables to ensure… more
- BrightSpring Health Services (Louisville, KY)
- Our Company BrightSpring Health Services Overview The Licensure and Provider Enrollment Specialist will be a member of the Corporate Legal Department and will work ... with all Medicare and Medicaid enrollment applications and related renewals across...Business BrightSpring Health Services provides complementary home- and community-based pharmacy and provider health solutions for complex populations in… more
- Access Dubuque (Dubuque, IA)
- …End Date 20260105 Featured Job TH Ad TH Comments **Similar Jobs** Software Quality Assurance Specialist Cottingham & Butler/ SISCO Client Service Representative ... Representative Specialist I-full time **MercyOne** 1 Positions ID: TRHEUS00630033MERCYO...payments & ensures that patients meet financial requirements including Medicare medical necessity, payer pre-certifications & referrals. Provides general… more
- Carle Health (Normal, IL)
- …rounds and initiates timely referrals to other internal healthcare team members ( quality improvement, risk manager, social workers, pharmacy , therapy services, ... Transportation Deliver or delegate delivery of regulatory letters for Medicare and observation patients. Arrange/attend any patient/family care conferences. About… more
- Polaris Pharmacy Services, LLC (Fort Lauderdale, FL)
- …Remote Position Type Full Time Job Category Pharmaceutical Description PRIOR AUTHORIZATION SPECIALIST (REMOTE) WHO WE ARE At Polaris Pharmacy Services, we're ... Authorization Technician - Remote Job Details Job Location Polaris Pharmacy Services of Ft Lauderdale - Ft. Lauderdale, FL...services. As industry leaders, we're raising the bar for quality and coordination across all sites of care, ensuring… more
- Henry Ford Health System (Troy, MI)
- Primary Objectives To supervise, organize and coordinate the HMO, Medicare Advantage and Federal Government call center operations associated with HAP's Customer ... of the call center productivity. + Ensure compliance with the Centers for Medicare & Medicaid Services (CMS) and other regulatory agency guidelines, such as NCQA.… more
- CenterWell (Marietta, GA)
- …advanced practice professionals, Pharm D, Care Coach Nurse, MA, Behavioral health specialist , Quality based Coder, Referral Coordinator and more. Our approach ... Knowledge of Medicare guidelines and coverage. + Knowledge of HEDIS quality indicators. **Additional Information:** + Guaranteed base salary + bi-annual bonus +… more
- CenterWell (Coral Springs, FL)
- …advanced practice professionals, Pharm D, Care Coach Nurse, MA, Behavioral health specialist , Quality based Coder, Referral Coordinator and more. Our approach ... We are a value based care provider focused on quality of care for the patients we serve. Our...for TB. **Preferred Qualifications:** Active and unrestricted DEA license Medicare Provider Number/ Medicaid Provider Number Experience managing … more
- CenterWell (Phoenix, AZ)
- …advanced practice professionals, Pharm D, Care Coach Nurse, MA, Behavioral health specialist , Quality based Coder, Referral Coordinator and more. Our approach ... Knowledge of Medicare guidelines and coverage. + Knowledge of HEDIS quality indicators. + Bilingual is a plus. **Additional Information** + Guaranteed base… more