- Sun Pharmaceuticals, Inc (Princeton, NJ)
- …our global workforce is bound by our common values: **Job Summary:** The Rebate Analyst will work closely with Contract Strategy to ensure all payer agreements are ... that processes, evaluates, and analyzes sales contracts for US markets. The Rebate Analyst will be responsible for the overall Contract Administration for Sun Pharma… more
- CareFirst (Baltimore, MD)
- **Resp & Qualifications** **PURPOSE:** The Senior Medicaid Encounters Risk Adjustment Analyst assumes a pro-active approach in ensuring the accuracy and ... business process and technical workflow documents. + Understand Medicaid risk score methodology, including risk score calculation, financial risk receivable… more
- Fairview Health Services (Minneapolis, MN)
- …oversee the management of third-party external reviews for Medicare and Medicaid lines of business . **Additional Responsibilities** + Demonstrates proficiency ... **Job Overview** Establish and maintain patient access to Fairview Pharmacy services across the system (26 Retail pharmacy sites; 11 Acute Care pharmacy … more
- AmeriHealth Caritas (Charleston, SC)
- …policy and operational procedures to effectively provide technical expertise and business rules. + Participate in encounter rejection reconciliation activities. + ... 1 to 2 years managed care or related experience preferred. + 1 to 2 years Medicaid experience preferred. + 2 to 5 years of claims analysis experience in a healthcare… more
- Queen's Health System (Honolulu, HI)
- …B. EXPERIENCE: * In addition to the educational requirement, three (3) years pharmacy operations, business operations or finance experience, preferably in a ... monitoring and routine auditing of virtual inventory accumulation, purchasing procedures, Medicaid billing procedures, patient eligibility, new areas of service, and… more
- Humana (Louisville, KY)
- …caring community and help us put health first** The Vice President, Medicaid Clinical Economics & Quality provides strategic and operational leadership for clinical ... effectiveness within the Medicaid segment. This function integrates Medical Economics, Clinical Insights, and Quality to deliver improved health outcomes, optimized… more
- Elevance Health (Louisville, KY)
- …of new technologies and a strong, clinical-first lens, to deliver member-centered, lasting pharmacy care. The ** Business Analyst II** will support Clinical ... **Formulary Business Analyst II - CarelonRx** **Location:**...Experience with Excel skills strongly desired. + _PBM or pharmacy experience (eg pharmacy technician, Formulary Product… more
- CareFirst (Baltimore, MD)
- **Resp & Qualifications** **PURPOSE:** The Senior Risk Adjustment Business Operations Analyst assumes a pro-active approach in ensuring the accuracy and ... operational requirements for Medicare Advantage(MA), Affordable Care Act (ACA) & Medicaid Lines of Business (LOB). Additional responsibilities include… more
- Prime Therapeutics (Jefferson City, MO)
- …those we serve. Looking for a purpose-driven career? Come build the future of pharmacy with us. **Job Posting Title** Compliance Analyst Principal - Remote **Job ... Supports new client implementations + Supports all lines of business (commercial/HIM, Medicare and Medicaid ) + Other...legal or compliance related roles for a healthcare or Pharmacy Benefit Management organization, or within a highly regulated… more
- Prime Therapeutics (Topeka, KS)
- …for those we serve. Looking for a purpose-driven career? Come build the future of pharmacy with us. **Job Posting Title** Regulatory Analyst Sr - Remote **Job ... Description** The Senior Regulatory Analyst is responsible for leading portions of departmental regulatory review and analysis, external audits and accreditation… more
