- Henry Ford Health System (Troy, MI)
- GENERAL SUMMARY: Responsible for handling of daily pharmacy duties such as drug claim adjudication issues, prior authorization, and pharmacy benefit inquiries ... and external individuals. Subject matter expert in the resolution of pharmacy benefit coverage issues and coordinating prior authorization and exception processes.… more
- Corewell Health (Grand Rapids, MI)
- …claims payments, billing and enrollment, care management, medical, pharmacy and behavioral health authorizations, customer service interactions, prescription ... in plan documents have been interpreted accurately and consistently, determine if pharmacy and medical policies have been applied appropriately or if additional… more
- Henry Ford Health System (Rochester Hills, MI)
- …based performance measurements are vital to success. EDUCATION/EXPERIENCE REQUIRED: + Associate 's Degree in Computer Science or related field. Relevant experience ... care, health insurance, a full suite of home health offerings, virtual care, pharmacy , eye care and other health care retail. With former Ascension southeast… more
- Henry Ford Health System (Troy, MI)
- …and in a timely effective manner. + Serve as first line contact for A&G Analyst for day to day operational issues. + Function as a liaison with plan-wide ... Membership & Billing, Health Care Management, Coordinated Behavioral Health Management, Pharmacy Care Management, Claims, Provider Services, and Sales. + Partner… more