4 director of pharmacy services jobs found

Overview The Director of Pharmacy is responsible for supporting the AVP of Medical Cost Containment in the implementation, process improvement, and optimization of clinical programs. The Director of Pharmacy will be responsible for analytic measurement and improvement of medical management of their assigned programs. These programs may include pharmacy and other associated operational processes and interventions. This role will achieve outcomes by focusing on analytics, clinical operations, and development of new programs to support organizational vision, and cost savings. Maintains a solid understanding of AmTrust’s mission, vision, and values. Upholds the standards of the AmTrust organization. Responsibilities Serve as a business owner for medical product management needs specific to pharmacy program and establishing key performance indicators, identifying opportunities, and driving business goals Manage a team of 8...

The Professional Review Specialist analyzes medical services and billing across various claim types to evaluate the accuracy of charges and the medical necessity of care provided. This is a hybrid position until fully trained. Training will be full-time onsite. ESSENTIAL FUNCTIONS & RESPONSIBILITIES: Identify the necessity of the review process and communicate any specific issues of concern to the claims examiner/client and or direct reporting manager Collect supporting data and analyze information to make decisions regarding appropriateness of billing, delivery of care and treatment plans Appropriately document work and final conclusions in designated computer program Additional duties as assigned   KNOWLEDGE & SKILLS: Thorough knowledge of ICD Diagnoses and Procedure Codes, and C.P.T., as well as an understanding of medical terminology Knowledge of applicable fee schedule and or applicable U&C Guidelines Proficient...

The Bill Review Supervisor is responsible for the supervision of all operations within their designated department. This position functions as a member of the Bill Review Department leadership team, ensuring optimum team performance by providing exemplary support and assistance to achieve the organizational goals of excellent customer service of the bill review department and of CorVel. This is a Hybrid role. In office full time for training, then hybrid once fully trained. ESSENTIAL FUNCTIONS & RESPONSIBILITIES: Directs a team of employees in their day-to-day operations and the quality of services provided, focusing on production, timeliness, and quality of bill review performance Establishes employee performance goals and follow-up to ensure employees are achieving goals, providing encouragement, training, and coaching as needed Evaluates and maintains appropriate staffing levels to ensure work is completed within internal and external customer turn-around time...

Who Are We? Taking care of our customers, our communities and each other. That’s the Travelers Promise. By honoring this commitment, we have maintained our reputation as one of the best property casualty insurers in the industry for over 170 years. Join us to discover a culture that is rooted in innovation and thrives on collaboration. Imagine loving what you do and where you do it. Job Category Claim Compensation Overview The annual base salary range provided for this position is a nationwide market range and represents a broad range of salaries for this role across the country. The actual salary for this position will be determined by a number of factors, including the scope, complexity and location of the role; the skills, education, training, credentials and experience of the candidate; and other conditions of employment. As part of our comprehensive compensation and benefits program, employees...