Financial Analysis and Modeling Lead the development and enhancement of revenue and claim estimates, encompassing critical components such as risk scores and adjustments, trend analysis, drug rebates, reinsurance recoveries, and reserves. Utilize advanced modeling techniques to provide accurate and insightful financial projections. Team Development Build and mentor a high

Eligible for a $2,500 sign on bonus Eligible for Full Time benefits Shift Full Time Day Shift The Pharmacy Benefits Specialist is responsible for handling drug claim adjudication issues, prescription prior authorization, and pharmacy benefit inquiries from members/patients, physicians, pharmacies, and other internal and external individuals. Is a subject matter expert in

Under general supervision, responsible for all functions relating to ensuring that all appropriate practitioners are enrolled in government programs and commercial health plans. Primary responsibilities include taking a new provider application from receipt to inclusion in directory and making ongoing updates. Responsibilities include data entry, data collection, analysis