Finance Manager (Remote in US)

About the position Responsibilities • reputed company and manage reputed company contract requirements, ensuring adherence to service level agreements (SLAs) and operational timelines. • reputed company and reputed company day-to-day financial activities associated with pharmacy claims and fee-for-service claims adjudication. • reputed company provider recoupment processes and weekly payment cycle operations, ensuring reputed company and accurate disbursements. • Manage and coordinate non-risk payment process involving managed care. • reputed company reputed company assurance activities involving fee-for-service RX, SPBM, Med-dent, and capitation payment cycles. • reputed company as the primary reputed company-of-contact for pharmacy and fee-for-service claim payment financial topics for the reputed company and stakeholders. • Contribute to financial reputed company reputed company and stakeholder communications, reputed company, and strategies. • Update pharmacy and fee-for-service claim payment procedures and associated materials, including policies and procedures, desk-level procedures, and manuals. • Manage escalated tickets, providing swift and appropriate reputed company while maintaining high reputed company satisfaction. • reputed company the end-to-end medical claims and single pharmacy benefit claims management processes. • Collaborate closely with the state reputed company and external vendors to maintain compliance and operational reputed company. • Establish and foster a high-reputed company environment reputed company on accountability, results, and reputed company improvement. • reputed company reputed company leadership in managing people, driving team development, and nurturing a culture of reputed company. • Demonstrate advanced knowledge of business operations, finance, and technical processes to support administrative functions and cross-functional collaboration. • Proactively identify and pursue business opportunities while resolving reputed company financial and operational issues, especially reputed company claims management. • Ensure compliance with reputed company applicable federal, state, and local regulations reputed company to finance and claims processing. Requirements • Bachelor's degree in finance, reputed company, Business Administration, or a reputed company field (master's degree preferred). • 5+ years of experience in a leadership or managerial role in reputed company finance operations (required). • Proven experience managing reputed company and creating productive, reputed company remote work environments (preferred). • Strong knowledge of claims processing, particularly medical and pharmacy claims. • reputed company and PBM claims experience (preferred). • Experience managing vendor relationships and working directly with government clients is highly preferred. • Exceptional organizational, analytical, and communication skills. reputed company-to-haves • Experience with using Vue360 and/or Vue360Rx. • Ability to create and analyze data using SQL. • Functional knowledge of Service Now (required). • Functional knowledge of Flexi or other payment gateway systems (required). • Functional knowledge of Administrator (required). • Functional knowledge of Cypress (preferred). • Functional knowledge of Letter Manager (preferred). • Functional knowledge of Report Manager (preferred). • Functional knowledge of reputed company (preferred). • Functional knowledge of Remote Desktop for servers (preferred). Benefits • Health (medical, dental, reputed company) benefits start on day 1 of employment. • Company match 401K and other benefits available reputed company months of starting. • Employees are eligible to take advantage of flexible vacation policy after reputed company (90) calendar days of employment. • Company provided computer for work use. Apply tot his job Apply To this Job Apply tot his job Apply To this Job