- Wittenberg Weiner Consulting LLC (Santa Fe, NM)
- …attention to detail and adherence to FEMA guidelines. Claims Reviewers - Senior ( Team Lead) will objectively review , investigate, process, evaluate ... Copperhead is seeking multiple Claims Reviewers - Senior ( Team Leads) for a potential contract to support disaster relief. This position involves receiving,… more
- Walgreens (Santa Fe, NM)
- …experience. + Models and shares customer service best practices with all team members to deliver a distinctive and delightful customer experience, including ... pharmacist, including those to physicians. + Processes (corrects and resubmits) manual claims for third party program prescription services in a timely and efficient… more
- Cardinal Health (Santa Fe, NM)
- …as a primary liaison and expert on the business in support of the Litigation team . + Advises business unit leaders on terms, risks and due diligence during mergers ... laws and regulations, including the Anti-Kickback Statute, the False Claims Act, Stark Law, HIPAA and other laws applicable...business clients + Working under the general supervision of senior attorneys and exercising sound judgment as to matters… more
- Cardinal Health (Santa Fe, NM)
- …and enhance the overall healthcare experience. We are seeking a highly motivated and experienced Senior Data Scientist to join our team as a thought leader and ... ensuring alignment with our overall business objectives. + Guide and mentor a team of Data Scientists and ML Engineers by providing technical guidance, mentorship,… more
- Prime Therapeutics (Santa Fe, NM)
- …our passion and drives every decision we make. **Job Posting Title** Senior Data Scientist **Job Description** The Data Scientist designs and develops processes ... to support clinical program using eligibility, medical, and pharmacy administrative claims . This position is responsible for performing work that includes study… more
- United Therapeutics (Santa Fe, NM)
- …you drive a culture of compliance with confidence and enthusiasm. The Senior Corporate Compliance Manager - Training, Communications and Policy will be responsible ... + POLICIES & PROCEDURES: + Drive compliance through the development, review /update and implementation of principles-based Compliance policies and procedures in… more
- Highmark Health (Santa Fe, NM)
- …quotes and analyzes the structure of a contract for a group based on claims experience, characteristics of the employee groups, etc. The incumbent uses discretion of ... questionable claim patterns of renewal clients and issues with competitor's claims experience for prospect clients and develops recommendations to account for… more
- Datavant (Santa Fe, NM)
- …care. By joining Datavant today, you're stepping onto a high-performing, values-driven team . Together, we're rising to the challenge of tackling some of healthcare's ... Lead Data Engineer specializing in healthcare data pipelines to join our team . The ideal candidate will have expertise in designing, developing, and maintaining… more
- Molina Healthcare (Santa Fe, NM)
- …to technical system enhancements by performing user testing.* Participate as a team player by assisting peers and Management to support department goals.* Trains ... party administrators. + Performs enrollment functions to include call tracking, claims workflow, and encounter requests for verification and updates, PCP assignment… more
- Otsuka America Pharmaceutical Inc. (Santa Fe, NM)
- …performance of the Quality Systems and Risks will be reported periodically to Senior Management through the Management Review process to ensure alignment with ... Executive Director of R&D Global Quality to join our team . This pivotal role will be responsible for leading...for Clinical vendor management and vendor oversight. + **Management Review :** Establish and maintain a system to ensure R&D… more
- Prime Therapeutics (Santa Fe, NM)
- …make. **Job Posting Title** Sr. Market Pricing Analyst - REMOTE **Job Description** The Senior Market Pricing Analyst serves as a trusted partner to our health plan ... revised financial pricing strategies based on analysis of pharmacy claims data, average wholesale drug prices (AWP), health plan...pricing data + Collaborate with sales and account management team as well as other internal functional areas to… more
- Prime Therapeutics (Santa Fe, NM)
- …forecasting, revenue projections, and analysis in support of the Pricing and Analytics team , as well as other functional areas throughout Prime. This position is ... + Provide analysis and conclusions for moderately complex analytical work + Forecast claims and membership in support of company and client revenue forecasting +… more
- Walgreens (Santa Fe, NM)
- …experience. + Models and shares customer service best practices with all team members to deliver a distinctive and delightful customer experience, including ... pharmacist, including those to physicians. + Processes (corrects and resubmits) manual claims for third party program prescription services in a timely and efficient… more
- Highmark Health (Santa Fe, NM)
- …quotes and analyzes the structure of a contract for a group based on claims experience, characteristics of the employee groups, etc. The incumbent develops and uses ... of financial exhibits. This is an entry level position, with oversight by Senior Underwriters and/or Management until the individual is acclimated to the Company… more
- Cardinal Health (Santa Fe, NM)
- …services required for hospital-level care at home. Candidates should be adaptable, team -oriented, and capable of working independently in a fast-paced setting with ... cross-functional colleagues across the AHS order entry and revenue cycle management team , Compliance, the Enterprise Privacy Office, and other internal teams to… more
- Prime Therapeutics (Santa Fe, NM)
- …Applied Stars and Quality Analytics Analyst - Remote **Job Description** The Senior Health Data Analyst provides information, analyses, and consultation to internal ... STARS experience + Experience conducting complex analysis on large sets of pharmacy, claims , medical, and/or financial data + Intermediate SAS or SQL coding skills +… more