Pharmacy Claims Adjudication Specialist - New Hyde Park

We are seeking a Pharmacy Adjudication Specialist at our Specialty pharmacy in New Hyde Park, NY. This will be a Full-Time position. · This position must be located within driving distance to our pharmacy, · a hybrid work style.This job requires adjudicating pharmacy claims and r ...

The Clinical Pharmacy Specialist is responsible for the development, implementation, and maintenance of drug formularies, · and overseeing pharmacy benefit claims adjudication to match formulary intent.Develops and monitors the hospital's policies/procedures regarding utilization ...

The Clinical Pharmacy Specialist is responsible for the development and implementation of drug formularies and clinical utilization management criteria. This role involves critical evaluation of clinical literature to support P&T Committee decisions. · Develops and monitors polic ...

The Clinical Pharmacy Specialist is responsible for the development, implementation and maintenance of drug formularies, · Develops and monitors the hospital's policies/procedures regarding utilization of medications in collaboration with the medical staff. · ...

The Claims Audit Coordinator is responsible for auditing claims processing activities to ensure compliance with HCP guidelines. · ...

The Claims Audit Coordinator role involves auditing claims processing activities to ensure compliance with HCP guidelines. · ...

The Claims Specialist will coordinate activities critical to the successful completion of clinical studies and review projects.This role supports appeal and dispute adjudication programs by monitoring requests, coordinating with clinical partners, managing provider and contractor ...

The Claims Specialist will coordinate activities critical to the successful completion of clinical studies and review projects. · ...

Build your career while building NYC schools The Construction Management Department administers all Capital projects performed in existing public school buildings and the construction of new schools. Job Description Summary Project Officer - I is responsible for managing and coor ...

Build your career while building NYC schools. · The Construction Management Department administers all Capital projects performed in existing public school buildings and the construction of new schools. · Project Officer - II is responsible for managing and coordinating personnel ...

This position involves managing and coordinating personnel, budget, administration and operational activities involved in all phases of assigned school construction projects. · ...

Serve as technical and business content expert to develop and manage processes and data to ensure the accuracy and timeliness of members' pharmacy benefit administration driving towards a great member experience. · ...

Support Systems Operations leadership providing guidance and execution support for eligibility and benefits implementation and management. · ...

MetroPlusHealth is committed to empowering New Yorkers by uniting communities through care. · Inputs all received medical benefit and pharmacy benefit prior authorization requests into our processing platforms. · ...

+We are seeking a highly skilled and experienced Clinical Operations Specialist to ensure proficiency with the adjudication platform, understanding claim processing, and providing clinical review support. · Serve as an account support to internal EmpiRx Health teams for adjudicat ...

+Job summary+We are looking for a highly capable Senior Construction Defect Technical Claims Specialist to join our team. · +Qualifications / Experience Required+A minimum of seven years' experience adjudicating construction defect with extensive experience with exposure of $100, ...

MetroPlusHealth busca un Claims Adjustment Specialist I para analizar reclamaciones de salud post-pagos estandarizadas o complejas e identificar posibles errores en el pago. · ...

We are looking for a highly capable Senior New York Labor Law Technical Claims Specialist to join our team and work from our New York City office. · A Brief Overview · Working under limited oversight under broad management direction, adjudicate New York Labor Law claims at the hi ...

We are looking for a highly capable Senior Environmental Technical Claims Specialist to join our team. · This individual will report to a manager who works in New York City and is focused on adjudicating first and third party commercial environmental claims (mostly complex storag ...

We are looking for a highly capable Senior Environmental Technical Claims Specialist to join our team. · This individual will report to a manager who works in New York City · ...