- St. Luke's Health System (Boise, ID)
- …of colleagues, St. Luke's is truly a great place to work. **Overview:** The Senior Pharmacy Benefits Specialist assists our members in identifying and navigating ... complex pharmacy benefits management (PBM) and third-party issues such as...pharmacy benefits. + Facilitate resolutions to issues involving claims adjudication, member concerns, and provider communications. + Addresses… more
- Marshfield Clinic (Marshfield, WI)
- …law and third-party reimbursement rules. **Preferred/Optional:** Three years' experience in pharmacy claims processing. Experience in technical writing and ... to support the most exciting missions in the world!** **Job Title:** Pharmacy Systems Support Specialist Senior **Cost Center:** 301641560 System Ancillary… more
- Centene Corporation (Austin, TX)
- …a Monday - Friday; 2:00 pm - 10:30 pm EST, schedule.** **Position Purpose:** The Senior Pharmacy Resolution Specialist will act as a subject matter expert and ... everything for our 28 million members as a clinical professional on our Medical Management/Health Services team. Centene is...handles more complex pharmacy issues and respond to escalated calls from members,… more
- Access Dubuque (Dubuque, IA)
- …Managed Solutions Group Business Office Coordinator - Dyersville-Part time MercyOne Senior Commercial Bodily Injury Claims Adjuster Cottingham & Butler/ ... Inpatient Pharmacy TIS Coordinator MercyOne Sales Executive - Casualty Claims (Fully Remote) Cottingham & Butler/ SISCO Event Coordinator Cottingham & Butler/… more
- Trinity Health (Westerville, OH)
- **Employment Type:** Full time **Shift:** Day Shift **Description:** Certified Pharmacy Technician Senior will assist the pharmacist in delivering timely, ... exceptional customer service by addressing patient questions and concerns. The Certified Pharmacy Technician Senior is expected to participate in quality… more
- BrightSpring Health Services (Eugene, OR)
- … 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
- State of Massachusetts (Boston, MA)
- …vehicles deemed appropriate to inform the Division's various audiences. The Director of Pharmacy Benefit Manager Oversight is a senior management level position ... be required to evaluate carriers' compliance with coding and claims practices. * Oversee the licensure of Pharmacy...to MGL c. 176Y. * Coordinate and communicate with senior management staff to ensure that staff are aware… more
- Humana (Lansing, MI)
- …operational, professional , and clinical activities for the purposes of pharmacy program development for our Fully Integrated Dual Eligible Special Needs Plan ... problems of diverse scope and complexity ranging from moderate to substantial. The Pharmacy Director, internally known as a Clinical Pharmacy Lead, plans,… more
- UTMB Health (Galveston, TX)
- Analyst, 340B Program - Contract Pharmacy **Galveston, Texas, United States** **New** Allied Health UTMB Health Requisition # 2504846 **_REQUIRED EDUCATION / ... degree in business, accounting or finance_** + **_3 years' experience with pharmacy 340B Drug Pricing Program_** + **_3 years' experience in business and… more
- UHS (Johnson City, NY)
- …Provide immunizations and other health screenings in compliance with state laws and pharmacy protocols + Manage and verify insurance claims and prior ... United Health Services (UHS) is seeking a dedicated Pharmacist to join our pharmacy team. The Pharmacist will ensure the safe and accurate administration of… more
- Catholic Health Services (Centereach, NY)
- …and PowerPoint Experience in Epic or similar EMR platforms Experience with retail pharmacy prescription processing and claims adjudication Prior experience on ... clinical providers with the goal of optimizing the provision of specialty pharmacy services, pharmaceutical care, and patient outcomes related to medication usage.… more
- Comcast (Philadelphia, PA)
- …we want you to fast-forward your career at Comcast. **Job Summary** The Senior Director of Global Benefits is responsible for designing and implementing health care ... health care financial forecasting/underwriting principles including self-insured medical and pharmacy plan administration and payment models. + Provides oversight… 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
- Otsuka America Pharmaceutical Inc. (Princeton, NJ)
- …recommendations. + Strong command of pharma data sources (eg, IQVIA, Symphony, Komodo, claims data, specialty pharmacy , field activity data). + Proficient in ... The Senior Manager, Brand Analytics, Nephrology, is a high...KPIs, dashboards, and monthly business reviews. + Analyze sales, claims , patient-level, and field force data to track brand… more
- Elevance Health (Middletown, NY)
- …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 . Health insurance experience required with understanding of health… more
- Ascendis Pharma (Princeton, NJ)
- …grow and develop their skills. Ascendis Pharma is looking to hire a Senior Manager, Contract Operations to join our team. Responsibilities will include implementing ... demonstrating strong leadership, project management, and communication skills. As the Senior Manager, Contracting Operations, you will be responsible for working… more
- Access Dubuque (Dubuque, IA)
- …+ Great Benefits! Medical Associates Cardiac Sonographer - PRN Medical Associates Senior Commercial Bodily Injury Claims Adjuster Cottingham & Butler/ SISCO ... Registered Nurse (RN) Senior Care **MercyOne** 1 Positions ID: TRHEUS00590875MERCYO Posted...will promote excellence in nursing practice and a thriving professional practice environment, as evidenced by our designation as… more
- Ankura (Chicago, IL)
- …The position has tremendous growth potential with one of the leading professional services firms in the United States. Ankura's Disputes and Economics Healthcare ... Life Sciences sector in matters relating to compliance with the federal False Claims Act; Anti-Kickback Statute; Food Drug and Cosmetic Act; Department of Justice… more
- Amgen (Thousand Oaks, CA)
- …from various payer datasets including patient level claims data, payer claims data, formulary coverage and specialty pharmacy data; 6. Evaluate effectiveness ... transform the lives of patients while transforming your career. ** Senior Manager, Value & Access Insights** **What you will...of others, we also work to care for your professional and personal growth and well-being. From our competitive… more
- CSL Behring (King Of Prussia, PA)
- …in specialty/rare disease data strongly preferred including acquisition and integration of specialty pharmacy data and use of secondary claims data (eg IQVIA ... As the Senior Director of Sales Operations & COE you...related field required. MBA Highly Preferred **Experience** -15+ years professional experience, 8+ years' experience within the pharmaceutical industry.… more