Fraud Manager I

As a licensed health care professional employed in the Pharmacy Prior Authorization Department your primary responsibility is to make determinations on prior authorization and coverage requests for pharmaceutical products. Determinations include medical necessity and benefit decisions. Decisions are made in accordance with established pharmacy guidelines,...

Department Responsibilities: The Individual(k) operations teams are responsible for all the day-to-day processing needs for our BF/ IK clients. These needs include initial plan setup, plan reconciliations (including research), processing distributions and new loans, deconversions, and 5500 EZ preparation. The operations team supports our internal and...

Duties: As a licensed health care professional employed in the Pharmacy Prior Authorization Department your primary responsibility is to make determinations on prior authorization and coverage requests for pharmaceutical products. Determinations include medical necessity and benefit decisions. Decisions are made in accordance with established pharmacy...

Duties: As a licensed health care professional employed in the Pharmacy Prior Authorization Department your primary responsibility is to make determinations on prior authorization and coverage requests for pharmaceutical products. Determinations include medical necessity and benefit decisions. Decisions are made in accordance with established pharmacy...

Job DescriptionJob DescriptionDuties: The primary purpose of the job is to: Under the general supervision of the Supervisor of Pharmacy Prior Authorization Technicians, the Pharmacy Services Technician I assists in the prior authorization process. Responsible for reviewing and approving physician or member inquiries for pre-authorization and medical...

Job DescriptionJob DescriptionDutiesThe primary purpose of the job is to: Under the general supervision of the Supervisor of Pharmacy Prior Authorization Technicians, the Pharmacy Services Technician I assists in the prior authorization process.Responsible for reviewing and approving physician or member inquiries for pre-authorization and medical necessity...

Duties: The primary purpose of the job is to: Under the general supervision of the Supervisor of Pharmacy Prior Authorization Technicians, the Pharmacy Services Technician I assists in the prior authorization process. • Responsible for reviewing and approving physician or member inquiries for pre-authorization and medical necessity requests based on...

Overview: It’s an exciting time to be at OSL Retail Services, working for a people focused company that’s at the top of its game. The momentum we’ve generated in recent years with our commitments to client customers, innovation, business results, and an entrepreneurial spirit has created energy, enthusiasm, and engagement among our employees that is...

**Description** Penn Medicine is dedicated to our tripartite mission of providing the highest level of care to patients, conducting innovative research, and educating future leaders in the field of medicine. Working for this leading academic medical center means collaboration with top clinical, technical and business professionals across all...

WMS Analyst IAre you a tech-savvy problem solver with a passion for optimizing warehouse management systems? Do you love analyzing data and collaborating with cross-functional teams to deliver top-notch results? If you're nodding your head "yes" to these questions, then we want YOU!As our WMS Analyst I, you'll be our go-to guru for implementing and...

This is an on-site second shift (2pm-10pm) role. WMS Analyst IAre you a tech-savvy problem solver with a passion for optimizing warehouse management systems? Do you love analyzing data and collaborating with cross-functional teams to deliver top-notch results? If you're nodding your head "yes" to these questions, then we want YOU!As our WMS Analyst I, you'll...

Hours of performance: Subcontractor shall work 40 hours per week, (2000 hours annually) Monday through Friday, excluding 11 days of Federal holidays.Telework: The division will provide training before telework is available. Once they are considered trained and ready, they will be allowed to telework (3 days in the office and 2 days telework).Performance...

Job Title: Service Desk Agent I Department: Information Technology Services Location: Philadelphia Employment Status: Full Time, Non-Exempt Position Summary: The Service Desk Agent I serves as the primary contact for the MIS/Telecommunications Department, providing essential assistance to PCOM staff, faculty, and students with basic computer-related...

Job Title: Service Desk Agent I Department: Information Technology Services Location: Philadelphia Employment Status: Full Time, Non-Exempt Position Summary: The Service Desk Agent I serves as the primary contact for the MIS/Telecommunications Department, providing essential assistance to PCOM staff, faculty, and students with basic computer-related...

Section 1: Position SummaryThe Content Specialist will be responsible for strategy, content development, execution, and oversight related to key Marketing campaigns and initiatives. Through consultation, creativity, and a focus on sound UX, this individual will be responsible for collaborating with key stakeholders to implement effective communications plans...

At Ascensus, technology is more than just a solution. It powers the business that helps millions of people save for what matters—retirement, education, and healthcare.  Our technology experts tackle exciting challenges in collaborative teams, but work in an environment where individual and career development is always valued.  Technology associates...

Job DescriptionJob DescriptionPerformance Duties:Subcontractor will perform a variety of financial analysis and investigative services in support of the investigation and prosecution of residential mortgage-backed securities cases and will report to the Chief of the Civil Division.Analyze publicly available materials, governmental databases, and other such...

Nuvem's Pharmacy Management Team is looking for a compassionate, patient centric Pharmacist to manage and grow our pharmacy presence. Our goal is to make you feel empowered in the role that you play when managing your pharmacy, personnel, client relationships/clinic support and patient population. As the pharmacy manager, you will be responsible in managing...

Nuvem's Pharmacy Management Team is looking for a compassionate, patient centric Pharmacist to manage and grow our pharmacy presence. Our goal is to make you feel empowered in the role that you play when managing your pharmacy, personnel, client relationships/clinic support and patient population.As the pharmacy manager, you will be responsible in managing...

Job DescriptionJob DescriptionDescription:Nuvem’s Pharmacy Management Team is looking for a compassionate, patient centric Pharmacist to manage and grow our pharmacy presence. Our goal is to make you feel empowered in the role that you play when managing your pharmacy, personnel, client relationships/clinic support and patient population.As the pharmacy...