- CVS Health (Scottsdale, AZ)
- …And we do it all with heart, each and every day. **Position Summary** As the Medicare Pharmacy Audit Programs Project Manager you will be responsible ... for administering Medicare Part-D Pharmacy Audit Programs . In this...for a CVS Health bonus, commission or short-term incentive program in addition to the base pay range listed… more
- Prime Therapeutics (Columbus, OH)
- …passion and drives every decision we make. **Job Posting Title** Manager, Client Audit Services - Remote **Job Description** The Manager Client Audit Services ... department priorities as determined collaboratively with compliance leadership for client audit management (CAM). This position assists in the analysis, design,… more
- Trinity Health (Columbus, OH)
- …review. . Coordinate and work with PBM and internal departments related to the pharmacy audit requests. . Trend and identify inappropriate pharmacy ... variety of professional roles including information technology, financial analysis, audit , provider relations and more. **Position Purpose:** Pharmacy /Clinical… more
- UPMC (New Castle, PA)
- …or equivalent required AND one of the following: + Completion of an accredited pharmacy technician program + Six months of previous pharmacy technician ... + Completion of high school diploma or equivalent OR Completion of an accredited pharmacy technician program AND one of the following: + Two years of… 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
- 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
- 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 (Lebanon, NH)
- …on a day to day basis. This job builds on the responsibilities of a Pharmacy Technician Certified III. Dartmouth is the best where it matters most! DH Offers You: ... applicable. Tuition Reimbursement:Up to $3,000 per year. Dental Vision \# Pharmacy Technician, #Dartmouth-Hitchcock Pharmacy Responsibilities * Answers Phones.… more
- BrightSpring Health Services (Englewood, CO)
- …of all Accounts Receivable, including but not limited to, Government, Medicare , Medicaid, and commercial insurances. The Collections Manager will perform all ... company goals and objectives + Develops and implements training programs to keep the team updated on the latest...receivable and ensure accurate financial reporting + Participates in audit and compliance activities to ensure all information is… more
- The Cigna Group (St. Louis, MO)
- …, Compliance, Legal and other stakeholders to respond to State, Center for Medicare and Medicaid Services (CMS) and Client audit requests. **Key accountabilities ... **Overview** The Advisor Regulated Markets Audit Management role is responsible for coordinating the...experience participating in regulatory and/or performance audits in a pharmacy benefit services or managed care environment + 2… more
- BlueCross BlueShield of North Carolina (NC)
- **Job Description** Oversees the Medicare Prescription Payment Plan (M3P), working closely with internal matrix partners and external vendors to ensure all aspects ... of the program are administered timely, accurately and in compliance with the Centers for Medicare and Medicaid Services (CMS) requirements. Ensures that future … more
- VNS Health (Manhattan, NY)
- …staff handling grievances and appeals across our Managed Long Term Care (MLTC), Medicare Advantage (MA), or Select Health product lines. * Ensure Compliance: Stay ... will help us navigate the ever-evolving healthcare landscape. * Monitor and Audit : Collaborate with subcontractors, ensuring they meet our high standards for… more
- CVS Health (Orlando, FL)
- …do it all with heart, each and every day. **Position Summary** CVS Health Specialty Pharmacy , a mail service pharmacy in the Monroeville area has an opportunity ... A/R billing activities. Additionally, the Compliance Analyst, Revenue Cycle may assist the audit team by collecting necessary documentation for audit requests as… more
- The Cigna Group (Jefferson City, MO)
- …operations accountabilities associated with all regulated lines of business including Medicare , Medicaid, and Marketplace (Exchange / Health Care Reform). The team ... supports Pharmacy Benefit... Benefit Management (PBM) delegated responsibilities associated with regulatory audit support, issue management, adjustment processing, Prescription Drug Event… 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
- Baylor Scott & White Health (Dallas, TX)
- **Position Overview:** The Director of Quality Analytics & Audit will lead all quality analytics, reporting, and audits for the Baylor Scott & White Health Plan ... across Medicare , Medicaid, Commercial and Exchange populations. The Director will...enhance quality, improve outcomes, and meet regulatory requirements in programs including the National Committee for Quality Assurance (NCQA)… 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
- LA Care Health Plan (Los Angeles, CA)
- …Summary The Specialty Plans Auditor III is responsible for planning audits and audit work programs that address appropriate claims and financial compliance ... Care's Specialty Health Plans. Plans specialty audits and develops audit work programs which address state or...of LA Care deficient delegates. Participates in Centers for Medicare and Medicaid Services (CMS) claim audit … more
- CenterWell (Austin, TX)
- …Technician 4 assists with a team of skilled auditors reviewing timeliness requirements for Medicare initial episodes of care and reports out on the same. The Quality ... of others and/or is the primary administrative owner of a main process, program , product or technology. The Quality Assurance Technician 4 works within broad… 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