- Highmark Health (Sacramento, CA)
- **Company :** Highmark Inc. **Job Description :** **JOB SUMMARY** Work with Pharmacy Markets business owners, stakeholders and other management, as required, to ... achieve Pharmacy Markets growth objectives. Organize and coordinate Pharmacy Markets activities to focus on the successful delivery of desired results. Monitor… more
- CVS Health (Sacramento, CA)
- …opportunity to join our PBM Finance Enablement group as a Senior Reporting Analyst within our PBM Customer Reporting team. CVS Health strives to continuously ... You will work with a collaborative, close-knit team on pharmacy and member specific claims data including, but not...standard and ad-hoc client and regulatory Prompt Pay and Pharmacy Payment Compliance reporting using SQL and SAS. You… more
- Baylor Scott & White Health (Sacramento, CA)
- + **JOB SUMMARY** The Risk Adjustment Analyst Sr is responsible for monitoring and oversight of the end-to-end encounter management workflow. This position analyzes ... TPA business requirements preferred.Experience with healthcare encounters, enrollment and pharmacy data preferred. **BENEFITS** Our competitive benefits package includes… more
- CVS Health (Sacramento, CA)
- …each and every day. **Position Summary** As a Healthcare Encounter Senior Analyst for claim reconciliation in the State Medicaid Encounters department, you will ... work exclusively with Pharmacy generated Medicaid encounters. You will be responsible for researching, analyzing and correcting previously submitted, rejected,… more
- Evolent (Sacramento, CA)
- …**What You'll Be Doing:** **Who You'll Be Working With:** The Senior Analyst Performance Suite Analytics utilizes and develops project management tools to solve ... + Perform research and analysis of complex healthcare claims, eligibility, and pharmacy data regarding health plan cost & use and make recommendations based… more
- Cardinal Health (Sacramento, CA)
- …500. We currently have a career opening for a Reimbursement Solutions Analyst . **What Clinical Operations contributes to Cardinal Health** Clinical Operations is ... regimens as insurance indicates + Discuss medication options with pharmacy /physician and patient based on accessibility and availability (outpatient environment)… more
- Molina Healthcare (Sacramento, CA)
- **JOB DESCRIPTION** **Job Summary** The Analyst , Risk and Quality Reporting role supports Molina's Risk and Quality Health Plan team. This position designs and ... Develop custom health plan reports related to managed care data like Medical Claims, Pharmacy , Lab and HEDIS rates + Assists and collaborates with the national Risk… more
- Centene Corporation (Sacramento, CA)
- …of the following areas: claims, provider data, member data, clinical data, HEDIS, pharmacy , external reporting + Extract, load, model, and reconcile large amounts of ... data across multiple system platforms and sources + Review data to determine operational impacts and needed actions; elevate issues, trends, areas for improvement and opportunities to management + Develop reports and deliverables for management + Model data… more
- CVS Health (Sacramento, CA)
- …it all with heart, each and every day. **Position Summary** The Specialty Pharmacy Off-Phone Audit Manager leads the internal audit function for CVS Specialty's ... to develop and implement the annual audit plan for pharmacy task functions including intake, benefits verification, order scheduling,...Ability to be a mentor to less experienced Business Analyst and team members to drive compliance for best… more