199 results (9 new)
Remote
•
Yesterday
Medical Claims or Pharmacy claims or membership information. SQL Server and SQL writing Some recent experience with Data modeling & Data Warehousing (Any platform is ok, does not have to be snowflake) EDI transaction experience API integration into Data Warehouse with EDI 834 and 837. This is not a BA role
Easy Apply
Contract
$50+
Remote
•
10d ago
Reports to: Chief Executive Officer Employment Type: Full-time Work Arrangement: Fully remote in USA only Compensation: $200,000$240,000 About the RoleWe are seeking a strategic Vice President of Pharmacy Benefit Management (PBM) to build and lead our in-house PBM. Reporting directly to the CEO, this leader will oversee the transition from outsourced PBM services to an internally managed model, establishing the processes, infrastructure, and team needed for long-term success. Initially, the ro
Easy Apply
Full-time
Depends on Experience
Remote
•
24d ago
Duties The pharmacy technician supports the organizations mission and purpose by providing front-line customer support for a diverse portfolio of customers.This individual will be responsible for handling inbound telephone inquiries from members, pharmacies, and prescribers in our National Customer Care Center.Consistently meet established productivity, schedule adherence, and quality standards. Responsibilities Provide real-time support to pharmacies with point of service inquiries.Educate pres
Easy Apply
Contract
20 - 22
Remote
•
Yesterday
What youll do Gather, analyze and translate pharmacy claims workflow requirements into Business Requirements Documents (BRDs), Functional System Specifications (FSDs) and user stories with clear acceptance criteria. Map transaction data fields across NCPDP Version F6 standards, including Eligibility Verification (E1), Claim Billing (B1), Claim Reversal (B2), Claim Rebill (B3) and Predetermination of Benefits (D1). Analyze field-level changes between NCPDP D.0 and F6, including: expanded field le
Easy Apply
Contract
Depends on Experience
Remote
•
Yesterday
We are seeking to hire a Advisor (Lead) Data Analyst with expertise in Medicare / Pharmacy Benefits Management systems, to join our teams working on a new multi-year awards we have within several State Govt clients, modernizing their Medicare/Medicaid systems. These roles are 100% remote. Being a US Cit is required for working on this program. This position pays a strong salary package with full benefits (including choice of healthcare plans, dental, vision, life insurance, 3 weeks PTO, 11 Paid
Easy Apply
Full-time
Depends on Experience
Remote
•
Today
Job Description Summary #LI-Remote This position can be based remotely anywhere in the U.S. (there may be some restrictions based on legal entity). Please note that this role would not provide relocation as a result. The expectation of working hours and travel (domestic and/or international) will be defined by the hiring manager. This position will require 20% travel. Job description summary The Data Innovation, Partnerships and Products (DIPP) team sits within the Data Products and Foundatio
Full-time
USD 185,500.00 - 344,500.00 per year
Remote or Massachusetts
•
Today
We're building a world of health around every individual - shaping a more connected, convenient and compassionate health experience. At CVS Health , you'll be surrounded by passionate colleagues who care deeply, innovate with purpose, hold ourselves accountable and prioritize safety and quality in everything we do. Join us and be part of something bigger - helping to simplify health care one person, one family and one community at a time. Position Summary CVS Health Specialty is looking for ha
Full-time
USD 106,605.00 - 260,590.00 per year
NTT DATA, Inc.
Remote or Frisco, Texas
•
Today
About NTT DATA NTT DATA strives to hire exceptional, innovative, and passionate individuals who want to grow with us. If you want to be part of an inclusive, adaptable, and forward-thinking organization, apply now. We are currently seeking a professional to join our team in Frisco, Texas (US-TX), United States (US). Day to Day job Duties: (what this person will do on a daily/weekly basis) Provide L2/L3 application and operational support for pharmacy systems, ensuring high availability and t
Full-time
USD 45.00 - 55.00 per hour
NTT DATA, Inc.
Remote or Frisco, Texas
•
Today
Req ID: 389976 NTT DATA strives to hire exceptional, innovative and passionate individuals who want to grow with us. If you want to be part of an inclusive, adaptable, and forward-thinking organization, apply now. We are currently seeking a Pharmacy Application Support Engineer (L2 / L3 Support) - REMOTE to join our team in Frisco, Texas (US-TX), United States (US). Day to Day Responsibilities: Provide L2/L3 application and operational support for pharmacy systems, ensuring high availability a
Full-time
USD 78,948.00 - 120,615.00 per year
Remote or Mission, Kansas
•
Today
Who is ScriptPro? Imagine working at a place where innovation meets impact, and every day brings new opportunities to revolutionize the pharmacy industry! At ScriptPro, you'll be part of a dynamic team that's at the cutting edge of technology, creating solutions that make a real difference in people's lives. ScriptPro develops, sells, and supports state of the art robotics and services in thousands of pharmacy settings around the United States and Canada. ScriptPro's Customer Service department
Full-time
USD 24.00 - 27.00 per hour
Remote or Mission, Kansas
•
Today
Who is ScriptPro? Imagine working at a place where innovation meets impact, and every day brings new opportunities to revolutionize the pharmacy industry! At ScriptPro, you'll be part of a dynamic team that's at the cutting edge of technology, creating solutions that make a real difference in people's lives. ScriptPro develops, sells, and supports state of the art robotics and services in thousands of pharmacy settings around the United States and Canada. ScriptPro's Customer Service department
Full-time
USD 24.00 - 27.00 per hour
Washington, District of Columbia
•
Today
Pay: $275,000 ? $300,000 per year Schedule: Full Time, Day Location: MedStar Georgetown - 2233 Wisconsin Ave MedStar Job ID: 171915 Senior Health Plan Medical Director - MedStar Family Choice, Washington DC We are looking for a physician with senior level health plan experience to join MedStar Family Choice, our Medicaid Managed Care Organization, as the Senior Health Plan Medical Director in Washington, DC. Key Position Details This position serves as a key thought partner and advisor to the
Full-time
Compensation information provided in the description
Columbia, Maryland
•
Today
Pay: $275,000 ? $300,000 per year Schedule: Full Time, Day Location: MedStar Health - Corporate (Columbia) MedStar Job ID: 170442 Senior Health Plan Medical Director/Medical Officer, Baltimore, MD - MedStar Family Choice We are looking for a physician with senior level health plan experience to join MedStar Family Choice, our Medicaid Managed Care Organization, as the Senior Health Plan Medical Director/Medical Officer in the Baltimore, MD region. Key Position Details This position serves as
Full-time
Compensation information provided in the description
Remote or Washington, District of Columbia
•
Today
Optum is a global organization that delivers care, aided by technology to help millions of people live healthier lives. The work you do with our team will directly improve health outcomes by connecting people with the care, pharmacy benefits, data and resources they need to feel their best. Here, you will find a culture guided by inclusion, talented peers, comprehensive benefits and career development opportunities. Come make an impact on the communities we serve as you help us advance health op
Full-time
USD 112,700.00 - 193,200.00 per year
Arlington, Virginia
•
22d ago
A client of Innova Solutions is immediately hiring for a Public Sector Marketing Consultant. Position type: Full-Time Contract (W2) Role: Public Sector Marketing Consultant Duration: 3 to 6 Months Contract Location : Reston VA (Hybrid + travel) We are seeking a dynamic and results-driven B2B Public Sector Partner Marketer with 4-8 years of experience to join our team in support of a key enterprise technology client account. The ideal candidate will have a proven track record in B2B public se
Easy Apply
Contract
Depends on Experience
Kapitus
Remote or Arlington, Virginia
•
Today
Attention: Kapitus is aware that individuals posing as recruiters may be communicating with job seekers about supposed positions with Kapitus. Kapitus has received reports that the content and method of communication can vary, but messages may contain requests for payment (e.g., fees for equipment or training) and/or for sensitive financial information. Kapitus will never ask a candidate for employment for payment or financial information during the initial application or interview process. All
Full-time
USD 96,300.00 - 154,400.00 per year
Remote
•
2d ago
Engagement Manager / Medical Officer / Medical Affairs focus Location: East coast Preferred Boston / NY / NJ - Nearby location Essential Functions Be Client face for all medical affairs / Pharma Analytics engagements Serve as the SME and main client point of contact for Medical Affairs project engagements and internal team lead Liaise with client leadership and project team to ensure project output includes strategically sound and actionable recommendations and answers client business ques
Easy Apply
Full-time, Third Party
Depends on Experience
Washington, District of Columbia
•
Today
Our Company Optum is a global organization that delivers care, aided by technology to help millions of people live healthier lives. The work you do with our team will directly improve health outcomes by connecting people with the care, pharmacy benefits, and data they need to feel their best. Here, you will find a culture guided by diversity and inclusion, talented peers, comprehensive benefits, and career development opportunities. Come make an impact on the communities we serve as you help us
Full-time
USD 112,700.00 - 193,200.00 per year
Kapitus
Arlington, Virginia
•
Today
Attention: Kapitus is aware that individuals posing as recruiters may be communicating with job seekers about supposed positions with Kapitus. Kapitus has received reports that the content and method of communication can vary, but messages may contain requests for payment (e.g., fees for equipment or training) and/or for sensitive financial information. Kapitus will never ask a candidate for employment for payment or financial information during the initial application or interview process. All
Full-time
USD 117,800.00 - 189,000.00 per year
Remote
•
6d ago
Required Qualifications 15+ years of software quality assurance experience, including hands-on test design and execution. 5+ years of QA leadership or management experience. Strong experience supporting PBM claims processing systems. Deep understanding of SDLC, Agile execution, test estimation, risk-based testing, and release management. Ability to define and manage quality metrics, dashboards, and team performance indicators. Strong analytical, communication, stakeholder management, and proble
Easy Apply
Contract, Third Party
Depends on Experience
