Top 86 Pharmacy operations Jobs in Roselle Nj

Senior Specialist, Pharmacy Systems Operations - Remote
EmblemHealth —New York, NY
- $68,040 - $118,800 a year
- Remote
- Oracle
- Microsoft Outlook
- Mid-level
Pharmacy Product Project Manager - Hybrid/Remote
EmblemHealth —New York, NY
- $77,760 - $149,040 a year
- Remote
- 5 years
- Analysis skills
- Bachelor's degree
Dispensary Technician
Schwarzman Animal Medical Center —Newark, NJ
- $18 - $23 an hour
- Computer literacy
- Mid-level
- High school diploma or GED
- 403(b) matching
- Health insurance
Quick Apply
Office of the CEO, Associate
Pharmacy First Health —New York, NY
- $80,000 - $100,000 a year
- Full-time
- Hybrid work
- Mid-level
- Clinic
- 2 years
Quick Apply
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
Regional Director of Pharmacy - PPS
Partners Pharmacy —Springfield, NJ
- Monday to Friday
- 3 years
- Bachelor's degree
- Data entry
- Health insurance
- 401(k)
Pharmacist I
Newark Beth Israel Medical Center —Newark, NJ
- $71.40 an hour
- Day shift
- Hospital
- Mid-level
- Team management
- Disability insurance
- Health insurance
Pharmacy Operations Manager
Walgreens —Elizabeth, NJ
- $22.50 - $31.00 an hour
- Weekends as needed
- English
- Mid-level
- High school diploma or GED
- Continuing education credits
- Health insurance
6d
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
Staff Pharmacist – Independent Pharmacy | No Sundays | $55–$65/hr – Nutley, NJ
White Oak Pharmacy —Nutley, NJ
- $55 - $65 an hour
- Full-time
- HIPAA
- Mid-level
- Bachelor's degree
- Health insurance
- Dental insurance
Quick Apply
6d
Interim Director of Pharmacy - Contract
Soliant —Newark, NJ
- Weekends as needed
- Management
- Bachelor of Science
- Mid-level
Quick Apply
Assistant Manager, Pharmacy Operations - Atlantic Health Morristown Medical Center
Atlantic Health System —Morristown, NJ
- Full-time
- Mid-level
- 3 years
- Children
- 403(b) matching
- AD&D insurance
Pharmacy Technician
Kessler Institute for Rehabilitation - Welkind (Chester) —Chester, NJ
- $22 - $30 an hour
- Weekends as needed
- Inpatient
- High school diploma or GED
- Rehabilitation center
- Health insurance
- Dental insurance
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
Supervisor II
Cooperman Barnabas Medical Center —Livingston, NJ
- $56,000 - $70,000 a year
- Full-time
- Hospital
- Bachelor of Science
- Mid-level
- Paid parental leave
- Paid holidays
Formulary Operations Specialist
Judi Health —New York, NY
- $70,000 - $85,000 a year
- Salesforce
- Mid-level
- 3 years
Quick Apply
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
Director, Pharmacy
Atlantic Rehabilitation Institute —Madison, NJ
- $150,000 - $165,000 a year
- Full-time
- Hospital
- Bachelor of Science
- Bachelor's degree
- Disability insurance
- Health insurance
Quick Apply
12d
Director, (Alpha-1 Antitrypsin Deficiency) AATD Patient Support Services Strategy and Operations
Sanofi —Morristown, NJ
- $178,500.00 - $257,833.33 a year
- Hybrid work
- 7 years
- Bachelor's degree
- Case management
- Parental leave
3d
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
12d

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pharmacy operations jobs near roselle 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 roselle nj

Senior Specialist, Pharmacy Systems Operations - Remote

Pharmacy Product Project Manager - Hybrid/Remote

Dispensary Technician

Office of the CEO, Associate

Pharmacy - Operations Associate

Regional Director of Pharmacy - PPS

Pharmacist I

Pharmacy Operations Manager

Assistant Vice President of Pharmacy Operations

Staff Pharmacist – Independent Pharmacy | No Sundays | $55–$65/hr – Nutley, NJ

Interim Director of Pharmacy - Contract

Assistant Manager, Pharmacy Operations - Atlantic Health Morristown Medical Center

Pharmacy Technician

Director of Pharmacy Operations

Supervisor II

Formulary Operations Specialist

Deputy Director of Pharmacy Operations

Director, Pharmacy

Director, (Alpha-1 Antitrypsin Deficiency) AATD Patient Support Services Strategy and Operations

Pharmacy Technician

I want to receive the latest job alert for pharmacy operations in roselle nj

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