Regulatory Clinical Pharmacist - Health Plan Compliance
Medica
Medica is seeking a Clinical Pharmacist - Regulatory to support the Pharmacy department's regulatory compliance across Medicare, Medicaid, and Commercial lines. This office-based role oversees regulatory submissions, NCQA initiatives, and audits, coordinating with internal teams and external regulators. The position requires collaboration across departments to ensure compliant pharmacy services. Office role with onsite work required, 3 days per week. #J-18808-Ljbffr Medica
- Medica, a nonprofit health plan, is seeking a Clinical Pharmacist - Regulatory to oversee state and federal regulatory compliance for pharmacy services. This onsite role collaborates with regulators and internal teams, reviewing audits and developing policies. The position...RegulatoryHealth Insurance3 days per week
$113.4k - $194.4k
Description Medica is a nonprofit health plan with more than a million... ...member feels valued. The Clinical Pharmacist works collaboratively with... ..., clinical programs, regulatory requirements, and pharmacy... ...operational, regulatory, and compliance activities, including required...RegulatoryHealth InsuranceWork experience placementWork at office3 days per week- ...Remote Clinical Review Pharmacist – Work From Home Leverage your clinical knowledge in a fully... ...Evaluate prescriptions and treatment plans for safety, appropriateness, and... ...recommendations and decisions according to health-plan and regulatory requirements. Participate in...RegulatoryHealth InsuranceRemote workWork from homeFlexible hours
- Medica is a nonprofit health plan seeking an Delegate Improvement Analyst III to design metrics... ...analyses that drive quality and regulatory adherence. You will partner with DHS and... ...CMS during audits and collaborate across clinical, operational, and analytics teams to...RegulatoryHealth InsuranceRemote job
- ...Pharmacy Manager, Medical Pharmacy to lead clinical, financial, and operational strategy... ...while mentoring staff and ensuring regulatory compliance. The role is onsite with a 3-day-a-... ...PharmD or PharmD-BS with 5+ years in health-plan pharmacy and 2+ years in leadership...RegulatoryHealth InsuranceWork at office3 days per week
- Medica is a nonprofit health plan serving communities in Minnesota and beyond. The Senior Director Accounting/Finance provides strategic... ...and operational leadership for accounting, financial close, regulatory reporting, and financial systems, partnering with actuarial,...RegulatoryHealth Insurance
$113.4k - $194.4k
...Description Medica is a nonprofit health plan with more than a million members that... ...every member feels valued. The Clinical Pharmacist – Regulatory is responsible for supporting... ...federal clinical requirements and compliance. Oversight is supported through reporting...RegulatoryHealth InsuranceWork experience placementWork at office3 days per week$60.9 - $82.3 per hour
Job Summary: Provides clinical services to patients, such as immunizations... ..., ensuring the compliance with regulatory guidelines, company policies... ...Review/Retail Fill Process Pharmacist is responsible for ensuring... ...choice for pharmacy, retail and health services, building trusted...RegulatoryHourly payFlexible hoursShift work$56.6k - $97k
...Financial Analyst II Medica is a nonprofit health plan with more than a million members that serves communities in Minnesota,... ...reporting, and accounting functions supporting month-end close, regulatory compliance, and operational finance. This role prepares journal...RegulatoryHealth InsuranceWork experience placementWork at office3 days per week$100k - $150k
...with experience in business/corporate and regulatory law. Desired experience includes... ...and acquisitions, commercial transaction, compliance, and cannabis-specific regulatory matters... ...Accident and critical illness coverage Health Savings Account (HSA) and Flexible Spending...RegulatoryHealth InsuranceFlexible hours- ...spectrum of employee benefits and executive compensation issues, including health and welfare plans and retirement plans Counsel clients on compliance with evolving statutory and regulatory requirements affecting employee benefit programs Collaborate with attorneys...RegulatoryHealth Insurance
$150k - $257.2k
...Description Medica is a nonprofit health plan with more than a million... ...Operations, Technology, Legal, Compliance, Risk, Communications, Customer Service, Clinical, Human Resources, Finance, vendor... ...an active emergency. Ensure regulatory deadlines, contractual commitments...RegulatoryHealth InsuranceWork experience placementWork at office3 days per week$150k - $225.02k
Medica is a nonprofit health plan with more than a million members that serves communities... ...activities comply with Medica policies, regulatory, and legislative requirements,... ...ensuring organizational effectiveness, compliance, and alignment with enterprise priorities...RegulatoryHealth InsuranceWork experience placementWork at office3 days per week$88.8k - $152.3k
...Job Description Job Description Medica is a nonprofit health plan with more than a million members that serves communities in... ...provider network solutions that support organizational growth, regulatory compliance, network adequacy, provider access, and operational...RegulatoryHealth InsuranceWork experience placementWork at office3 days per week$56.6k - $97k
Medica is a nonprofit health plan with more than a million members that serves communities in Minnesota, Nebraska, Wisconsin, Missouri... ..., and accounting functions supporting month-end close, regulatory compliance, and operational finance. This role prepares journal entries...RegulatoryHealth InsuranceWork experience placementWork at office3 days per week$22.87 - $30.88 per hour
...to date on system, process, product, and regulatory changes. ~ Attend all team meetings... ...the employee handbook. ~ Adhere to compliance procedures and participate in required compliance... ...Medical, Dental, and Vision insurance, Health Savings Accounts, 401(k)/ESOP, Paid Time...RegulatoryHealth InsuranceHourly payFlexible hours$166k - $186k
...analyze employment-related trends and regulatory developments to proactively advise... ...ComplianceSupport internal investigations and HR compliance reviews, including privileged... ...other compensation offered):Multiple health insurance plan options.Employer contributions to...RegulatoryHealth InsuranceWork experience placementLocal areaFlexible hours$90k - $140k
...Foundations to support safety and environmental compliance across deep foundation and heavy civil... ...and implement site-specific safety and health plans. Conduct safety training and... ...with OSHA and other applicable regulatory requirements. Maintain safety records...RegulatoryHealth InsuranceFor contractorsFor subcontractorWork at officeRelocation packageNight shiftWeekday work$155k - $255k
....Develop long-term strategic plans and set business targets, budgets... ...customer experience.Risk & Compliance Management:Ensure that all... ...products comply with relevant regulatory requirements, internal policies... ...to colleagues, including health insurance coverage, wellness...RegulatoryHealth InsuranceFull timeWork at officeRemote workWork from homeFlexible hours$78k - $156k
...Employees can qualify for free medical coverage in our Health Investment Plan (HIP) PPO medical plan in the next calendar year.... ...process enhancements. Ensure data integrity and compliance with internal controls and regulatory requirements. Required QualificationsBachelor’s...RegulatoryHealth InsuranceLocal areaWorldwide$106k - $170k
...organizational effectiveness, workforce planning, talent management, employee... ...employee experience and compliance with employment laws and... ...system procedures, policies, and regulatory requirements.Support... ...compensation offered):Multiple health insurance plan options.Employer...RegulatoryHealth InsuranceWork experience placementLocal areaFlexible hours$134.6k - $230.8k
...Insight is improving the flow of health data and information to create a more... ...optimization, helping health plans navigate an increasingly complex regulatory environment while improving quality... ...Stars capabilities across HEDIS, Clinical Quality, Risk Adjustment, Pharmacy...RegulatoryHealth InsuranceMinimum wageFull timeWork experience placementInterim roleWork at officeLocal areaRemote work$97.6k - $138.6k
...management processes. Review actuals versus planned budget throughout project life cycle to... ...validation of adherence to security or regulatory standards.NERC CIP experience.Sarbanes-... ...Care Flexible Spending Account, Health Care Flexible Spending Account, Health Savings...RegulatoryHealth InsuranceFull timeContract workTemporary workFor contractorsWork experience placementFlexible hours3 days per week$99.3k - $198.7k
...60 countries.JOB DESCRIPTION:Quality Compliance Program ManagerWorking at Abbott At Abbott... ...for free medical coverage in our Health Investment Plan (HIP) PPO medical plan in the next... ...leaders across manufacturing, quality, regulatory, and commercial functions to drive key...RegulatoryHealth InsuranceWorldwideShift work- ...Fairview is seeking a Clinical Oncology Pharmacist to support... ...selection, formulary compliance, medication safety,... ...quality improvement, regulatory compliance, and medication... ...information systems and health IT tools to support... ...Safe TimeRetirement plans with employer...RegulatoryFull timeTemporary workRelocation packageShift work
- ...to employer-sponsored group health plan administration, including ERISA... ...state insurance law, HIPAA compliance, fiduciary governance, and... ...claims and appeals support, and clinical excellence initiatives. The... ...communications to ensure regulatory compliance and clarity Respond...RegulatoryHealth InsurancePermanent employmentContract workCasual workWork at officeRemote workFlexible hours
- ...Fairview is seeking a casual Pediatric Clinical Pharmacist to join our inpatient pediatric pharmacy... ...storage inspections and ensure regulatory complianceEducation & CollaborationServe... ...to participate in the Fairview 403(b) plan, earn Sick and Safe Time, and early access...RegulatoryContract workCasual workRelocation package
$50k
...We specialize in providing organizations with regulatory compliance training, continuing education, and upskilling solutions... ...opportunities Comprehensive benefits package, including health insurance and retirement plans Flexible remote work environment High-impact,...RegulatoryHealth InsuranceBase plus commissionRemote workFlexible hours$93.1k - $122.5k
...our team in Plymouth, MN as a Compliance Manager! About Us... ...culture. Support succession planning and employee growth within the... ...the Director of Compliance. Regulatory Compliance Ensure compliance... ...which may include: • Health Plans - Medical, dental, vision...RegulatoryHealth InsuranceFull timeTemporary workLocal areaImmediate start- ...largest pediatric health systems in the United... ...nine primary care clinics, multiple... ...Oncology Specialty Pharmacist and make a meaningful... ...requirements, and 340B compliance. In addition, this... ...outcomes* Ensure regulatory requirements in... ...projects*Ability to plan, design,...RegulatoryFull timePart timeLocal areaShift workNight shiftWeekend work
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