Jobs in Analyst

Support providers (pharmacists and physicians) with Commercial pharmacy/ specialty drug benefits analysis, drug coverage inquiries and prior authorization ESSENTIAL DUTIES AND RESPONSIBILITIES include the following. Other duties may be assigned. Answer telephones in an efficient and timely manner to lend appropriate assistance to providers Triage prior authorization requests under the supervision of a Clinical Pharmacist.…

Support providers (pharmacists and physicians) for Commercial pharmacy, drug coverage inquiries, and prior authorizations. Top 3 Required Skills/Experience – • 2 years of retail pharmacy experience • Computer and Microsoft office experience • Customer Service Required Skills/Experience – The rest of the required skills/experience. Include: • Basic Pharmacy and medical terminology • Pharmacy claim adjudication…

Top Three Technical Skills/Experience Minimum 1 year prior project experience in successfully supporting Delivery Managers and Leads in a project coordinator role including assisting project and program managers in creating and maintaining project planning documents (i.e. project schedule, work plans, change controls, reports, etc.) Minimum 1 year project experience in supporting an IT Systems Development…

Engagement Description –  The health care analyst will work alongside pharmacists in pharmacy services to assist with operational efforts on the medical oncology team. The employee will be responsible for handling inquiries related to utilization management and claims, maintaining, and creating relevant documents and communicating with vendor partners to obtain necessary information. Top 3…

Engagement Description – Work with vendor risk assessment process and tools. Document the issues and risks that arise from the assessments. Work with contract admins and vendor contacts to solve for the issues and risks. Work with VRM team to improve and elevate the vendor risk program. Work across other functions like – procurement, business,…

Minimum 1 year prior project experience in successfully supporting Delivery Managers and Leads in a project coordinator role including assisting project and program managers in creating and maintaining project planning documents (i.e. project schedule, work plans, change controls, reports, etc.) Minimum 1 year project experience in supporting an IT Systems Development Life Cycle (SDLC) project…

Engagement Description – PA Specialist in Pt B Pharmacy will support providers (physicians and other healthcare providers rendering medical care) with Medicare Part B drug coverage inquiries, and prior authorizations. Top 3 Required Skills/Experience – • 2-4 years Specialty and/or Retail Pharmacy • Experience in provider/member call center or helpdesk • Process prior authorization requests…

Engagement Description – We are seeking a highly skilled and experienced Penetration Tester to join our team. Our goal is to stand up a formal process to periodically scan, detect, prioritize, and report on the security posture and health of publicly accessible web applications and websites, by checking for known vulnerabilities and weak configurations. The…

Engagement Description – • Reviewing claim submissions and verifying claims processed correctly. • Auditing claims-making sure the system applied the correct benefits, pricing, and cost share values. o Comparing claims data to the members benefits and other policy documents. o Ensuring the system applied to correct allowed amounts using CMS fee schedules. o Confirmed system…

Top Three Skills/Experience Lead healthcare payor JAD sessions using both waterfall & agile methodologies, manage requirements and be able to communicate clearly/effectively (5 years) Perform high-level systems analysis work based on a defined set of requirements (5 years) Analyze and document information and data required to achieve business goals (5 years) Engagement Description: Working independently…

Engagement Description – Collect clarifications around specifications and develop custom measures for dashboard in collaboration with the Analytics and Insight team. Role requires data quality assurance, data analysis, and data modeling using SQL/Databricks. Top 3 Required Skills/Experience – • SQL/Databricks Programming • Healthcare claims experience • Strong troubleshooting skills Required Skills/Experience – The rest of…