- Highmark Health (Washington, DC)
- **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
- Prime Therapeutics (Washington, DC)
- … Analyst - Remote **Job Description** The Recovery & Resolution Analyst is responsible for recovering inappropriate pharmacy payments related billing ... systems for recoupment of audits and investigations performed by the Pharmacy Audit Operations and Special Investigations Unit (SIU) teams. **Responsibilities** +… more
- Prime Therapeutics (Washington, DC)
- …passion and drives every decision we make. **Job Posting Title** Sr. AI Business Analyst - Remote **Job Description** **Are you a Business Systems Analyst with ... to grow your career in the IT AI space.** The Sr. IT Business Systems Analyst (BSA) is responsible for serving as a key role solving highly complex system problems… more
- CVS Health (Washington, DC)
- …heart, each and every day. **Job Purpose and Summary:** Resource Planning Analyst is responsible for the real-time monitoring including current and upcoming week ... etc. Ensures closed loop communications with peers within Resource Planning (Long Range, Analyst II and Vendor RP) around deviations to metrics that impact the… more
- Prime Therapeutics (Washington, DC)
- …passion and drives every decision we make. **Job Posting Title** Senior Forecast Analyst - REMOTE **Job Description** The Senior Forecast Analyst is responsible ... of experience in detailed analytical work in financial, insurance, pharmacy benefits management, reporting & analytics, benefits consulting healthcare industries… more
- Prime Therapeutics (Washington, DC)
- …and drives every decision we make. **Job Posting Title** Data and Reporting Analyst Assoc- REMOTE **Job Description** The Associate Data & Reporting Analyst ... and modeling + PBM experience or experience working with medical claims, pharmacy claims, healthcare and/or benefits data + Experience in the implementation of… more
- Intermountain Health (Washington, DC)
- …lab and pathology, radiology, picture archiving and communications (PACS), cardiovascular, pharmacy , home care, long term care, population health, consumer and ... scheduling, time and attendance, customer relationship management) + The staff Analyst is responsible for providing technical support, configuration, and maintenance… more
- Prime Therapeutics (Washington, DC)
- …and drives every decision we make. **Job Posting Title** Performance Guarantee Analyst Sr - Remote **Job Description** The Senior Performance Guarantee Analyst ... managing end-to-end projects related to quality metrics and/or performance + Pharmacy Benefit Management (PBM) or healthcare industry experience Must be eligible… more
- Prime Therapeutics (Washington, DC)
- …passion and drives every decision we make. **Job Posting Title** Senior Actuarial Analyst - REMOTE **Job Description** The Senior Actuarial Analyst is ... reporting, and projections + Lead, perform, and review complex ad hoc pharmacy data mining and analyses to help investigate and answer challenging questions… more
- Prime Therapeutics (Washington, DC)
- …and drives every decision we make. **Job Posting Title** Sr. Compliance Analyst - Remote **Job Description** The Regulatory Inquiry & Complaints Senior Compliance ... Analyst assists in the implementation of Prime's compliance programs,...and resolve regulatory inquiries/complaints related to claims, contracting and pharmacy reimbursement. Works directly with business partners across the… more
- Baylor Scott & White Health (Washington, DC)
- + **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
- Intermountain Health (Washington, DC)
- …sustaining business processes and processes impacted by data and systems. The business analyst serves as the central point for interface changes for systems and ... + Previous experience with Tredium adjudication system. + Previous experience in pharmacy setting or PBM experience. + Strong organizational, data gathering and data… more
- Prime Therapeutics (Washington, DC)
- …passion and drives every decision we make. **Job Posting Title** Compliance Analyst Principal - Remote **Job Description** The Compliance Principal is responsible ... experience in legal or compliance related roles for a healthcare or Pharmacy Benefit Management organization, or within a highly regulated industry, including… more
- Highmark Health (Washington, DC)
- …+ Evaluates various claims submitted by Third Party Administrators (TPAs) and Pharmacy Benefit Managers (PBMs) on behalf of self-funded clients for compliance with ... **Preferred:** + 3 years of experience in a Stop Loss Claims Analyst role. **SKILLS** + Ability to communicate concise accurate information effectively. +… more
- Prime Therapeutics (Washington, DC)
- …passion and drives every decision we make. **Job Posting Title** Compliance Analyst Principal (Performance and Oversight) - Remote **Job Description** The Compliance ... experience in legal or compliance related roles for a healthcare or Pharmacy Benefit Management organization, or within a highly regulated industry, including… more
- Cardinal Health (District Of Columbia, DC)
- …markets share. + Form long standing customer relationships with Pharmacists and Pharmacy Technicians + Convert existing and potential customers' use of targeted ... products and ensure sustained and expanded sales of these products. + Identify market intelligence on competitive activity, communicate to appropriate internal resources in a timely manner; develop and implement sales plans to meet business goals. + Create and… more
- WTW (Arlington, VA)
- …specialty consulting services including clinical/health management program design, pharmacy solutions, disability/absence management strategies and claims audit ... services. Product-based solutions such as our pharmacy purchasing coalition round out our broad-based suite of offerings. **Explore an opportunity.** By joining… more
- Ivyhill Technologies LLC (Bethesda, MD)
- …to: The MHS GENESIS, Government data repositories such as P2R2 Virtual Analyst , M2 Data Mart, EDW, Population Health Operational Tracking and Optimization System, ... DMLSS, Medical Expense and Performance Reporting System, CMS, Defense Pharmacy System, Radiology and PACS, Automated Business System and Commanders' Resource… more