• Test Lead - Pharmacy Business Solutions

    EPAM Systems (New York, NY)
    …leading large, complex, cross-functional teams + Extensive knowledge of pharmacy claims adjudication , NCPDP protocols, formulary management, and benefit design ... E2E testing strategies + Develop and communicate test strategies covering pharmacy claims processing, NCPDP transactions, and benefit designs + Design test scenarios… more
    EPAM Systems (10/07/25)
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  • Utilization Review Registered Nurse I

    Centene Corporation (New York, NY)
    …DRG, HCPC reimbursement methodologies. + Documents rate negotiation accurately for proper claims adjudication . + Acts as liaison between the TRICARE beneficiary ... 28 million members as a clinical professional on our Medical Management/Health Services team. Centene is a diversified, national...plus holidays, and a flexible approach to work with remote , hybrid, field or office work schedules. Actual pay… more
    Centene Corporation (10/15/25)
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  • AI Innovation Lead - Data Science Lab

    Guardian Life (Albany, NY)
    …service logs. + Deliver solutions that enhance underwriting risk assessment, claims auto- adjudication , and customer servicing. Operational Excellence + Establish ... MA, Stamford, CT, Pittsfield, MA or Bethlehem, PA + Remote Candidates who can travel up to 20% of...individual's known limitations related to pregnancy, childbirth, or related medical conditions, unless doing so would create an undue… more
    Guardian Life (09/12/25)
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