- Prime Therapeutics (Columbus, OH)
- …licensed functions (Pharmacy Benefit Management (PBM), Third Party Administrator, Utilization Review Organization, Business, State registrations etc.); compile ... with us. **Job Posting Title** Compliance Analyst (Regulatory Change Management) - Remote **Job Description** The Compliance Analyst assists in the implementation of… more
- Prime Therapeutics (Columbus, OH)
- …licensed functions (Pharmacy Benefit Management (PBM), Third Party Administrator, Utilization Review Organization, Business, State registrations, etc); compile ... **Job Posting Title** Senior Compliance Analyst (Regulatory Change Management) - Remote **Job Description** The Senior Compliance Analyst assists in the… more
- Prime Therapeutics (Columbus, OH)
- …us. **Job Posting Title** Georgia Medicaid Clinical Account Manager - Remote **Job Description** Innovative business clinician accountable for building and ... fashion. + Demonstrates the value of pharmacy solutions (unit cost, utilization management & patient care enhancement). + Identifies opportunities for additional… more
- Prime Therapeutics (Columbus, OH)
- …of pharmacy with us. **Job Posting Title** Clinical Account Director - Remote **Job Description** The Clinical Account Director is responsible for the management ... specific clinical programs and drug strategy recommendations including drug formulary, Utilization Management programs, and other drug therapy related products and… more
- Prime Therapeutics (Columbus, OH)
- …pharmacy with us. **Job Posting Title** Network Management Consultant - Remote **Job Description** The Network Management Consultant is responsible for development, ... to update contract documents including agreements and applications for utilization in contracting/re-contracting activities based on new network participation… more
- Ryder System (Columbus, OH)
- _Job Seekers can review the Job Applicant Privacy Policy by clicking here (http://ryder.com/job-applicant-privacy-policy) ._ **Job Description** : **SUMMARY** This ... customers, insurance carriers, and third party claimants. Participates in large claim review calls and updates field operations personnel on claim status. Possess a… more
- Molina Healthcare (Cleveland, OH)
- …team and key stakeholder meetings (PowerPoint) * Coordinates and provides peer review of our quarterly national contract performance analysis by team members to ... stakeholders requiring decision support. * Evaluates, writes, and presents healthcare utilization and cost containment reports and makes recommendations based on… more
- Molina Healthcare (Cleveland, OH)
- …team and key stakeholder meetings (PowerPoint) + Coordinates and provides peer review of our quarterly national contract performance analysis by team members to ... stakeholders requiring decision support. + Evaluates, writes, and presents healthcare utilization and cost containment reports and makes recommendations based on… more
- Trinity Health (Columbus, OH)
- …**Shift:** Day Shift **Description:** The Clinical Documentation Specialists will concurrently review medical records and assist physicians in removing the barriers ... Minimum of 5 years acute care medical or surgical experience required; Utilization /Case Management, managed care, or Clinical Documentation and experience in ICD-10… more
- Molina Healthcare (OH)
- …a (RN) Registered Nurse who must hold a compact license. This is a Remote position, home office with internet connectivity of high speed required Work Schedule ... on set schedule) Looking for a RN with experience with appeals, claims review , and medical coding. JOB DESCRIPTION Job SummaryProvides support for clinical member… more