5 compliance analyst i jobs found

Job Description: Summary: This position is responsible for and participates in a wide range of provider, patient, and employer initiatives and programs. The pharmacist supports all of our lines of business which include Medicare, Commercial, Exchange (Marketplace) and Medicaid. The focus of the UM Pharmacist is to manage the quality, appropriateness, safety and cost of medications for our members through the medical management of drugs across our pharmacy and medical benefits. Essential Accountabilities: Level I Conducts drug prior authorization, exception and medical necessity reviews. Works with requesting providers or internal staff to determine whether the submitted clinical information and patient presentation meet the criteria for approval according to the drug policy, formulary availability, and specific coverage criteria. Conducts first line appeal and grievance reviews for medical and pharmacy drugs in accordance with compliance standards. Conducts...

Job Description Study Director I Classification: Schedule: Traditional Job Summary: The Study Director has overall responsibility for the technical conduct of all assigned tests as well as for the review, interpretation, analysis, documentation, and reporting of results. The study director is the single point of study control. The study director ensures all assigned studies are completed on time. Essential Duties: Scientific/General Ensure reports are compliant with current procedures. Ensure final reports accurately reflect the data, results, and conclusions of the testing. Act as a final signature for assigned studies. Collaborate on Customer Specification Sheets (CSS) etc. as assigned. Ensure sample and data traceability are maintained throughout testing. Ensure calculations and statistics accurately reflect the raw data. Ensure accuracy of raw data. Ensure test controls and monitors are accurately recorded and reviewed. Collaborate within...

Laboratory Manager I- Joglekar Lab Med-Immunology - Pennsylvania-Pittsburgh - (26000491) The Department of Immunology and Center for Systems Immunology is seeking a laboratory manager to manage a lab of 10+ individuals. The responsibilities of this position include performing cellular and molecular immunology experiments; assisting lab members in performing experiments; keeping a track of inventory, stocks; ordering and purchasing supplies; maintaining equipment and laboratory space. Must have extensive experience with various laboratory techniques, ability to manage experimental work, and ability to manage day to day operations of the laboratory. Organize the equipment and wet lab space devoted to these projects. Maintain mouse colonies and perform genotyping. Perform molecular, cell biological and biochemical experiments. Provide experimental assistance and scientific advice to lab members as well as scientific collaborators. Maintain accurate records of laboratory...

Job Title: Pharmacist, Clinical Staff I - Evenings 7-on/7-off Description Employment Status: Full time Shift: Evening (United States of America) Facility: 1906 Belleview Ave SE - Roanoke CP01 Carilion Medical Center. Requisition Number: R157628 Pharmacist, Clinical Staff I - Evenings 7-on/7-off (Open) How You’ll Help Transform Healthcare: $30,000 Sign-On and Up to $10,000 Relocation Carilion Clinic is a six-hospital health system located in beautiful Southwest Virginia. Carilion's flagship hospital, Carilion Roanoke Memorial Hospital, is a 763-bed academic medical center, level I trauma center, tertiary/quaternary referral center, and Certified Primary Stroke center that has consistently been ranked by US News as a Best Hospital in the state of Virginia. It is also affiliated with the Virginia Tech Carilion School of Medicine and has numerous post-graduate training programs, including multiple medical and surgical residencies and fellowships. Clinical Staff I...

Job Title: Pharmacist, Clinical Staff I - Day/Evening Description Employment Status: Full time Shift: Day/Evening (United States of America) Facility: 1906 Belleview Ave SE - Roanoke CP01 Carilion Medical Center. Requisition Number: R149726 Pharmacist, Clinical Staff I - Day/Evening (Open) How You’ll Help Transform Healthcare: $30,000 Sign-On Bonus with Up to $10,000 for Relocation Carilion Clinic is a six-hospital health system located in beautiful Southwest Virginia. Carilion's flagship hospital, Carilion Roanoke Memorial Hospital, is a 763-bed academic medical center, level 1 trauma center, tertiary/quaternary referral center, and Certified Primary Stroke center that has consistently been ranked by US News as a Best Hospital in the state of Virginia. It is also affiliated with the Virginia Tech Carilion School of Medicine and has numerous post-graduate training programs, including multiple medical and surgical residencies and fellowships. Clinical Staff I...