• Manager , Long Term Disability…

    Lincoln Financial (Providence, RI)
    …#:** 74886 **The Role at a Glance** We are excited to bring on a highly motivated Claims Manager to our Long Term Disability Claims Organization! As a ... will provide leadership and direction to a team of claims specialists, technical claim specialists, and lead...* Meeting all established quality assurance benchmarks. * Ensuring claims processing is consistent with applicable policies,… more
    Lincoln Financial (07/28/25)
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  • Sr. Analyst , Pharmacy Claims Adjudication

    CVS Health (Woonsocket, RI)
    … processes analysis. Facilitate effective solutions related to adjudication and processing of pharmacy and vaccine/medical claims , maintaining current services, ... resolution for incidents reported through the Store Support center related to claim transactions, initiatives, and to support our store colleagues. The Retail… more
    CVS Health (07/16/25)
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  • Pharmacy Benefit Manager Invoice Processor…

    CVS Health (Providence, RI)
    …files. + Reconciles and balances claims data and invoices in the claims processing system. + Coordinates client billing and invoice payments. + Communicate ... + Imports and monitors PBM claim data and invoice...years of experience with health care data entry and/or claims processing . + 1-3 years of customer service… more
    CVS Health (07/26/25)
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  • Project Manager - Third Party Client Audit

    CVS Health (Providence, RI)
    …measuring and monitoring the quality and effectiveness of work processes in claim processing and/or customer service that impact customer satisfaction, medical ... cost management, and operational efficiency. Meritain Health's Project Manager for Third Party Client Audits will be responsible for the following: + Manage… more
    CVS Health (07/18/25)
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  • Field Reimbursement Manager - East Region

    Otsuka America Pharmaceutical Inc. (Providence, RI)
    **Position Summary** The Field Reimbursement Manager (FRM) serves as the subject-matter expert on reimbursement, access, and coverage issues for our products, ... and their staff on matters related to access, coverage, reimbursement processes, claims submissions, and coding requirements + Analyze payer criteria and provide… more
    Otsuka America Pharmaceutical Inc. (05/23/25)
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  • Clinical Account Manager - Georgia PDL…

    Prime Therapeutics (Providence, RI)
    …needs. + Provides clinical operations input and support of client specific claims processing programs, coordinates implementations of clinical projects and ... and drives every decision we make. **Job Posting Title** Clinical Account Manager - Georgia PDL - Remote **Job Description** Innovative business clinician… more
    Prime Therapeutics (07/24/25)
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  • Senior Manager , Platform Engineer,…

    Otsuka America Pharmaceutical Inc. (Providence, RI)
    The Senior Manager , Platform Engineer, Operational Support will be responsible for managing and enhancing platform integrations across data systems, Salesforce ... offered money for equipment fees or some other application processing fee, even if claimed you will be reimbursed,...you will be reimbursed, this is not Otsuka. These claims are fraudulent and you are strongly advised to… more
    Otsuka America Pharmaceutical Inc. (07/16/25)
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  • Patient Nurse Case Manager - West Region

    Otsuka America Pharmaceutical Inc. (Providence, RI)
    The Patient Nurse Case Manager (PNCM) is a dynamic, field-based role that serves as a crucial educator for patients. This position helps to execute against a ... offered money for equipment fees or some other application processing fee, even if claimed you will be reimbursed,...you will be reimbursed, this is not Otsuka. These claims are fraudulent and you are strongly advised to… more
    Otsuka America Pharmaceutical Inc. (05/23/25)
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  • Senior Manager , Fleet & Sample Operations

    Otsuka America Pharmaceutical Inc. (Providence, RI)
    **Position Summary** The Senior Manager , Fleet & Samples Operations oversees the execution of field fleet logistics and pharmaceutical sample distribution. The role ... offered money for equipment fees or some other application processing fee, even if claimed you will be reimbursed,...you will be reimbursed, this is not Otsuka. These claims are fraudulent and you are strongly advised to… more
    Otsuka America Pharmaceutical Inc. (05/16/25)
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  • Sr. Manager , Medicaid Contract…

    Sumitomo Pharma (Providence, RI)
    …position is responsible for managing the Medicaid rebate team in receiving, processing , validating, trouble-shooting Medicaid claims and dispute resolution with ... it relates to Model N implementation and payment process. + Experience in processing Medicaid rebates preferably using Model N software application or other similar… more
    Sumitomo Pharma (07/09/25)
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