Pharmacy Claims Manager
2 days ago
The successful candidate will oversee the entire pharmacy claims review process to ensure accuracy, efficiency, and compliance. They will monitor and resolve discrepancies, including coding, eligibility, and pharmacy errors. Additionally, they will lead, mentor, and develop a team of claims specialists, set performance targets, and monitor team metrics to ensure operational excellence.
To qualify for this role, you should have at least 3 years of experience in pharmacy claims, healthcare claims management, or a similar field. Direct management experience is also required, preferably with a team. You should have a strong understanding of pharmacy benefit management processes, formularies, and claim adjudication systems. Experience with Medicare, Medicaid, and commercial insurance plans is preferred.
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Tampa, Florida, United States DeliverCareRx Pharmacy LLC Full timeAbout DeliverCareRx Pharmacy LLCDeliverCareRx Pharmacy LLC is a leading national home delivery hospice pharmacy licensed in all 50 states. We are partnered with Optum Hospice Pharmacy Services, the largest pharmacy benefit manager in the hospice industry.We are committed to providing effective solutions and high-touch customer service to ultimately improve...
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Clinical Services Manager
2 weeks ago
Tampa, Florida, United States CSI Pharmacy Full timeResponsibilitiesLeadership and Supervision: Directs, coordinates, and supervises all pharmacy activities, including drug preparation, sterile products preparation (if applicable), dispensing, and clinical pharmacy services.Team Management: Oversees day-to-day activities, supervises pharmacy staff, and ensures compliance with company policies and...
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Pharmacy Operations Manager
1 week ago
Tampa, Florida, United States Pharmscript Full timeOverview:At Pharmscript, we are committed to delivering exceptional pharmaceutical care services to our customers. As a Pharmacy Operations Manager, you will play a key role in ensuring the smooth operation of our pharmacy department.Key Responsibilities:Develop and implement effective operational strategies to optimize pharmacy performance.Collaborate with...
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Tampa, Florida, United States Optum Full timePharmacy Internship Program at OptumWe are offering a comprehensive pharmacy internship program for students and recent graduates interested in pursuing a career in pharmacy. As an intern, you will work alongside our experienced team at Genoa Healthcare, a pharmacy care services company within the UnitedHealth Group family.The internship provides a unique...
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Claims Processor
2 weeks ago
Tampa, Florida, United States Marpai Health Full timeJob Overview:Marpai Health, a pioneering technology company in the Third-Party Administration sector, seeks an experienced Claims Analyst to join its dynamic team. As a key member of our Claims Team, you will play a crucial role in ensuring the timely, accurate, and compliant processing of claims.About the Position:We are expanding our Claims Team, and this...
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Pharmaceutical Operations Director
4 weeks ago
Tampa, Florida, United States CSI Pharmacy Full timeJob Summary:Clinical Pharmacists at CSI Pharmacy direct, coordinate, and supervise all pharmacy activities, including drug preparation, sterile products preparation, dispensing, and clinical pharmacy services. They oversee day-to-day activities in the absence of the Pharmacy Manager, ensuring seamless operations. Travel to Nash is required quarterly to cover...
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Compensation Claims Professional
7 days ago
Tampa, Florida, United States CorVel Enterprise Comp, Inc. Full time**Job Overview**This is a hybrid position as a Medical Only Claims Specialist at CorVel Enterprise Comp, Inc.The primary goal of this role is to manage non-complex and non-problematic medical only claims and minor lost-time workers' compensation claims under close supervision.The ideal candidate should have excellent customer service skills, written and...
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Pharmacy Operations Manager
4 days ago
Tampa, Florida, United States FORVIS Full timeJob DescriptionWe are seeking an experienced Pharmacy Operations Manager to join our team at FORVIS. As a key member of our Healthcare Consulting team, you will support clients in the Pharmacy and Clinic Services space, focusing on compliance, program optimization, and financial performance.The successful candidate will have strong analytical and...
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Complex Claims Leadership Opportunity
4 weeks ago
Tampa, Florida, United States TrovaSearch Full timeAbout the RoleTrovaSearch is seeking an exceptional leader to join our team as Director of Complex Claims. As a key member of our leadership team, you will be responsible for overseeing the technical and operational performance of teams within the complex claims department.Key ResponsibilitiesLeadership and Management: Directly supervise managers and/or...
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Behavioral Health Pharmacy Professional
3 weeks ago
Tampa, Florida, United States Optum Full timeAbout the OpportunityWe are seeking a highly motivated and detail-oriented Pharmacist Intern - Behavioral Health to join our team at Optum in Tampa, FL. This is a full-time internship opportunity for 10 weeks from June to August.Location: Our office is located in Tampa, FL, with housing available for qualified candidates who are not local to the area.Company...
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Senior Insurance Claims Adjuster
1 week ago
Tampa, Florida, United States Jimmie Giles Financial Full timeJob SummaryWe are seeking a seasoned Senior Insurance Claims Adjuster to join our team at Jimmie Giles Financial. As a Field Liability Claims Specialist, you will be responsible for handling daily claims in the State of Florida area.The ideal candidate will have a minimum of 5 years' experience with daily Liability claims adjusting and be proficient in...
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Insurance Claims Adjuster
3 days ago
Tampa, Florida, United States USAA Full timeWhy Choose USAA?USAA is a leading financial services organization dedicated to serving the unique needs of U.S. military members and their families. With a mission to facilitate financial security, we strive to provide exceptional service and support.The role of Sr. Injury Adjuster at USAA offers an exciting opportunity for experienced professionals to join...
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Clinical Pharmacy Manager
3 weeks ago
Tampa, Florida, United States Walmart Full timeAbout UsAt Walmart, we are dedicated to helping our associates, customers, and communities live better. We believe that by understanding, respecting, and valuing diversity, we can make a positive impact in the lives of those we serve.What We OfferWe offer a competitive salary of $98,000.00-$172,000.00* and additional compensation including annual or...
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Senior Collector/Hybrid Specialist
3 weeks ago
Tampa, Florida, United States Sedgwick Claims Management Services Full timeAbout UsSedgwick Claims Management Services is a leading provider of claims management solutions.Salary and BenefitsThe estimated annual salary for this position is $60,000 - $80,000, depending on experience. We offer a comprehensive benefits package, including health insurance, 401(k) matching, and paid time off.Job DescriptionWe are seeking a highly...
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Claims Examiner
3 weeks ago
Tampa, Florida, United States Heritage MGA LLC Full timeJob SummaryWe are seeking a highly skilled Claims Examiner to join our team at Heritage MGA LLC. This is an exciting opportunity for a motivated individual to utilize their analytical and problem-solving skills in a fast-paced insurance industry setting.Key Responsibilities:Investigate and Evaluate Claims: Conduct thorough investigations of commercial...
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Tampa, Florida, United States Integro Professional Services, LLC Full timeJob DescriptionWe are a dynamic company looking to expand our team with skilled professionals who have a strong work ethic and a passion for delivering exceptional results.Role OverviewAs an Automotive Claims Specialist, you will play a vital role in our company's claims administration process, specifically related to automotive extended warranty claims....
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Claims Adjuster
3 weeks ago
Tampa, Florida, United States Jimmie Giles Financial Full timeJob DescriptionAt Jimmie Giles Financial, we are seeking experienced Liability daily claims Field Adjusters to handle claims in the State of Florida area. This is a full file handling role, including first contact, inspection, letters/payment, and close. To be successful, you must have at least 5 years' experience with daily Liability claims and be...
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Clinical Pharmacy Consultant
1 week ago
Tampa, Florida, United States Elevance Health Full timeJob OverviewIn this role, you will work as a clinical pharmacy support specialist, providing quality improvement initiatives to Medicare, Commercial, and Medicaid providers. The ideal candidate will live within 50 miles of the Tampa, Florida area.The estimated salary for this position is $80,000 - $110,000 per year, depending on experience.Key...
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Senior Litigation Attorney
4 days ago
Tampa, Florida, United States Kuhn Raslavich P.A Full timeSenior Litigation Attorney - Flood Claims Job DescriptionWe are seeking an experienced Senior Litigation Attorney to join our team at Kuhn Raslavich, P.A. This is an excellent opportunity for a motivated professional with a passion for flood insurance claims. The successful candidate will have a proven track record in handling complex flood insurance cases,...
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Senior Insurance Claims Specialist
3 weeks ago
Tampa, Florida, United States AdventHealth Full timeAt AdventHealth, we believe in the wholeness of each person and serve to uplift others in body, mind, and spirit.We are currently seeking a Senior Insurance Claims Specialist to join our team at AdventHealth Tampa. In this role, you will have the opportunity to work with a dynamic team of professionals who are passionate about delivering exceptional patient...