- UHS (Vestal, NY)
- …Provide immunizations and other health screenings in compliance with state laws and pharmacy protocols + Manage and verify insurance claims and prior ... OverviewUnited Health Services (UHS) is seeking a dedicated Pharmacist to join our pharmacy team. The Pharmacist will ensure the safe and accurate administration of… more
- Catholic Health Services (Centereach, NY)
- …and PowerPoint Experience in Epic or similar EMR platforms Experience with retail pharmacy prescription processing and claims adjudication Prior experience on ... clinical providers with the goal of optimizing the provision of specialty pharmacy services, pharmaceutical care, and patient outcomes related to medication usage.… more
- CDPHP (Albany, NY)
- …share these values and invites you to be a part of that experience. The Pharmacy Analytics Consultant provides direct support for both Pharmacy and Medical Drug ... internal and external stakeholders and management, as required, to achieve Pharmacy Markets strategy, growth, compliance, and affordability objectives across the… more
- CVS Health (Albany, NY)
- …Trifacta, Linux OS, GCP/ AWS/ Azure. + Experience working with medical and/or pharmacy claims data. + Experience in healthcare industry, including health ... to join our PBM Customer Reporting group as a Senior Reporting Analyst within our Compliance Pharmacy ...You will work with a collaborative, close-knit team on pharmacy and member specific claims data including,… more
- Elevance Health (Latham, NY)
- …referral, and use of proprietary data and claim systems for review of facility, professional and pharmacy claims . + Responsible for independently identifying ... **Investigator Senior ** **Supports the Payment Integrity line of business**...to recover corporate and client funds paid on fraudulent claims . Health insurance experience required with understanding of health… more
- Ankura (Lexington, NY)
- …The position has tremendous growth potential with one of the leading professional services firms in the United States. Ankura's Disputes and Economics Healthcare ... Life Sciences sector in matters relating to compliance with the federal False Claims Act; Anti-Kickback Statute; Food Drug and Cosmetic Act; Department of Justice… more
- CVS Health (Albany, NY)
- …each and every day. **Position Summary** We are seeking an experienced Senior Healthcare Fraud Investigator to join our Dental/ Pharmacy /Broker Investigative Team ... abuse. + Conduct Investigations to prevent payment of suspect or fraudulent claims submitted by insured's, providers, claimants and customers. + Researches and… more
- Centene Corporation (New York, NY)
- …one who changes everything for our 28 million members as a clinical professional on our Medical Management/Health Services team. Centene is a diversified, national ... of VPMA. + Provide medical leadership for all utilization management, pharmacy , case management, disease management, cost containment, and medical quality… more
- WTW (New York, NY)
- …specialty consulting services including clinical/health management program design, pharmacy solutions, disability/absence management strategies and claims ... all try to have some fun! + Exposure to Senior leadership and thought leaders across the firm At...etc. + Gain specialized knowledge in areas such as pharmacy , life and disability insurance, health equity and wellbeing,… more
- Humana (Albany, NY)
- …with business partners to uphold ethical standards and mitigate risks. The Senior Clinical Compliance Professional will support the Director of Compliance, ... or data requires an in-depth evaluation of variable factors. As the Senior Clinical Compliance Professional , you will develop and/or evaluate compliance… more