Top 98 Pharmacy operations Jobs in Fort Lee, Nj

Senior Specialist, Pharmacy Systems Operations - Remote
EmblemHealth —New York, NY
- $68,040 - $118,800 a year
- Remote
- Oracle
- Microsoft Outlook
- Mid-level
Claims Operations Analyst
EmpiRx Health, LLC —Montvale, NJ
- Full-time
- Research
- Office
- SQL
- Disability insurance
- Health insurance
Quick Apply
1d
Pharmacy - Operations Associate
Atria Health and Research Institute —New York, NY
- $20 - $22 an hour
- Urgent Care
- HIPAA
- Quality control
- Continuing education credits
- Health insurance
Quick Apply
Director of Pharmacy Operations
PurposeMed —New York, NY
- $180,000 - $210,000 a year
- Full-time
- Remote
- Travel
- Contracts
- Experience equivalent to degree accepted
- Health insurance
- Dental insurance
Quick Apply
Pharmacist
Zen Health —Port Washington, NY
- $64.06 - $78.15 an hour
- Full-time
- Mid-level
- Supervising experience
- In-person
Quick Apply
8d
Interim Director of Pharmacy - Contract
Soliant —Newark, NJ
- Weekends as needed
- Management
- Bachelor of Science
- Mid-level
Quick Apply
Staff Pharmacist
NEWTOWN PHARMACY INC —Queens, NY
- $60 - $70 an hour
- Part-time
- Anatomy knowledge
- Hospital
- HIPAA
Quick Apply
Pharmacy Intake Manager
Topaz HR —Bardonia, NY
- $65,000 - $90,000 a year
- Full-time
- Mid-level
- High school diploma or GED
- Ability to sit for extended periods
Pharmacy Product Project Manager - Hybrid/Remote
EmblemHealth —New York, NY
- $77,760 - $149,040 a year
- Remote
- 5 years
- Analysis skills
- Bachelor's degree
Vendor Relations Specialist
EmpiRx Health, LLC —Montvale, NJ
- $67,302 - $84,127 a year
- Full-time
- Microsoft Outlook
- Salesforce
- Mid-level
- Health savings account
- Health insurance
Quick Apply
4d
Manager Pharmacy
Montefiore Einstein —Bronx, NY
- $144,000 - $180,000 a year
- Full-time
- Hospital
- 5 years
- Inpatient
Subject Matter Expert, Pharmacy & Supply Chain
Translucent AI —New York, NY
- $175,000 - $250,000 a year
- Full-time
- System design
- Office
- SQL
2d
Deputy Director of Pharmacy Operations
MetroPlus Health Plan —New York, NY
- $175,000 - $183,909 a year
- Full-time
- Hybrid work
- Office
- Supervising experience
- Senior level
Pharmacist
St.Vincent's Hospital Westchester —Harrison, NY
- $75 an hour
- Inpatient
- Mid-level
- Outpatient experience
Quick Apply
Assistant Vice President of Pharmacy Operations
NYC Health + Hospitals —New York, NY
- $225,000 - $300,000 a year
- Online Application
- Microsoft Excel
- Hospital
- 5 years
- Commuter assistance
- Paid holidays
Clinical Operations Specialist
EmpiRx Health, LLC —Montvale, NJ
- $50,890 - $63,612 a year
- Full-time
- Microsoft Excel
- Microsoft Outlook
- Mid-level
- Health savings account
- Health insurance
Quick Apply
1d
Pharmacy Technician
Thrivewell Infusion —New York, NY
- $50,000 - $60,000 a year
- Customer service
- Mid-level
- Data entry
- Health insurance
- Dental insurance
Quick Apply
10d
AVP, Pharmacy - VIVO (Specialty & Retail Operations)
Northwell Health —New Hyde Park, NY
- $205,200 - $320,000 a year
- Full-time
- 7 years
- System design
- Senior level
Pharmacy Operations Specialist / Pharmacy Cashier
CO-OP CITY PHARMACY —Bronx, NY
- From $20 an hour
- Part-time
- Background check
- Spanish
- Customer service
- Paid time off
- Employee discount
Quick Apply
23h
Staff Pharmacist Part TIME
Best Pharmacy —Bronx, NY
- $65 - $95 an hour
- Part-time
- In-person
- Entry level
Quick Apply
3d

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pharmacy operations jobs near fort lee, nj

Senior Specialist, Pharmacy Systems Operations - Remote

EmblemHealth -
New York, NY

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Job Details

$68,040 - $118,800 a year

Qualifications

Microsoft Outlook
Bachelor's degree
IT experience within healthcare
Managing projects

Full Job Description

Summary of Job

Serve as pharmacy systems coding subject matter expert for Prior Authorization with a focus on medical drug claim processing, review of utilization management, PA processing, and appeals; as well as the following: claims processes and JUDI interoperability with FACETS edits and other connection troubleshooting. Provide technical and subject matter expertise support for implementations and day to day operations of Pharmacy functions and vendor coordination. Support operations for file transfer systems (configuration, deployment, pharmacy management and medical benefits, eligibility). Support operations for system integration, including monitoring files and transitions, fallout, and root cause analyses. Execute non-clinical Appeals from post claim edit process, and consistently maintain queue

Responsibilities

Collaborate in defining, gathering, reviewing, and editing business requirements for system updates, enhancements and migrations for claims projects.
Perform solution analysis review and provide concise direction to ensure that the proposed system solution meets established business protocols, and any mandates and compliance guidelines.
Partner with business analysts, business users and source system experts to produce claim processing output consistent with meeting overall goals.
Review daily, pended medical drug claims for accuracy.
Identify and implement solutions to support automation of claims or resolve with manual intervention.
Collaborate with clinical, formulary, payment integrity and other key players to ensure issues are accurately defined with an appropriate solution.
Submit and track medical claims system configuration requests related to RPC (Reimbursement Policy Committee) decisions, ensuring timely implementation and alignment with approved policy guidelines.
Work with business units to develop test strategies and scenarios from business requirements.
Accurately interpret and translate strategies and scenarios into test plans.
Analyze requirements, test documents and acceptance criteria which will effectively find defects that may exist in claims processing.
Act as a liaison and subject matter expert for day to day medical drug system-related technical questions and/or issues.
Troubleshoot and track all concerns on unpaid claims, working with key stakeholders and respond to all appropriate parties effectively within a timely manner.
Provide written progress report to leadership regarding the status of deliverables, issues, problems and corrective actions taken.
Perform other related tasks as directed or required

Qualifications

Bachelor’s degree required
4 – 6+ years of relevant, professional work experience (Required)
2+ years’ experience in one or more of the following: claims processing, pharmacy/coding, utilization management (Required)
Experience in a healthcare environment (Required)
Proficiency with MS Office - Word, Excel, Access, PowerPoint, Outlook (Required)
Advanced reporting system experience/knowledge - SAS, Oracle, etc. (Preferred)
Track record of successfully managing multiple tasks/projects with competing priority levels/deadlines (Required)
Ability to understand complex technical system requirements and translate into simple business language (Required)
Excellent communication skills - verbal, written, presentation, reporting, interpersonal (Required)
Attention to detail; ability to think critically; ability to identify, quantify, analyze and resolve issues (Required)

Additional Information

Requisition ID: 1000003227
Hiring Range: $68,040-$118,800

Apply Now

Refine Your Search

pharmacy operations jobs in fort lee, nj

Senior Specialist, Pharmacy Systems Operations - Remote

Claims Operations Analyst

Pharmacy - Operations Associate

Director of Pharmacy Operations

Pharmacist

Interim Director of Pharmacy - Contract

Staff Pharmacist

Pharmacy Intake Manager

Pharmacy Product Project Manager - Hybrid/Remote

Vendor Relations Specialist

Manager Pharmacy

Subject Matter Expert, Pharmacy & Supply Chain

Deputy Director of Pharmacy Operations

Pharmacist

Assistant Vice President of Pharmacy Operations

Clinical Operations Specialist

Pharmacy Technician

AVP, Pharmacy - VIVO (Specialty & Retail Operations)

Pharmacy Operations Specialist / Pharmacy Cashier

Staff Pharmacist Part TIME

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