HEALTHESYSTEMS

Healthesystems is a specialty provider of innovative medical cost management solutions for the workers' compensation industry. Our diverse suite of services includes a leading Pharmacy Benefit Management (PBM) program and Clinical Review Services as well as a revolutionary Ancillary Benefits Management (ABM) program for managing and adjudicating ancillary medical services. Leveraging powerful technology, clinical expertise and enhanced workflow automation tools, we provide clients with flexible programs that reduce the total cost of medical care while increasing the quality of care for injured ... workers. We are committed to developing new ideas to help our clients navigate the complex workers' compensation industry while achieving measurable results such as improved pharmacy transaction efficiency, network penetration and drug utilization. Our services are tailored to each of our client's needs to increase value and maximize results. Services include: A leading Pharmacy Benefit Management (PBM) program Comprehensive Clinical Review Services An unrivaled Ancillary Benefits Management (ABM) program Trending and Data Analytics tools Innovative Technology Solutions and Systems Integration Services To sign up to receive our news and views in workers' comp visit: http://workerscomprehensive.healthesystems.com/index.php For the latest edition of our Rx Informer industry journal visit: www.healthesystems.com/rxinformer More

View healthesystems Salary

Popular Jobs at  HEALTHESYSTEMS

Summary. The ABM Operations Support Analyst is responsible for analytical support of the business operations related to adjudication and fee schedule. They perform analysis and review of fee schedule changes, system/process failures, as well as, system and program performance controls. They serve as the primary point of contact for operational issues experienced by users of Healthesystems systems and services. This includes customers, external vendor partners and internal stakeholders.. Key Responsibilities - To simplify complexities for each customer. Demonstrates strong analytical skills, by... view job details

Summary. The role of the Customer Service Specialist is to build trusted relationships with our clients, their claimants and pharmacies by providing superior customer service to every caller.. Key Responsibilities - To simplify complexities for each customer. 1.  Works with Team Lead, Supervisor and Manager to resolve phone inquiries related to claims adjudication, eligibility verification, prior authorization and other Pharmacy Benefit Management, Ancillary Benefits Management and some Billing Verification Department functions as required.  Utilizes strong verbal and written communication, li... view job details

Summary. Proactively support the manager and department as needed to keep the department fully functioning and able to maintain/exceed expected outcomes. Managing and maintaining communications and information, clerical and administrative duties, planning, scheduling, office organization, research, information handling and guest services. Key Responsibilities - To simplify complexities for each customer. Effectively utilize proprietary, industry specific and general MS Office software to support the needs of the department (i.e. report generation, spreadsheets, tracking mechanisms, presentatio... view job details

Summary. Responsible for the day to day management and maintenance of relationships with ABM vendors.  Focusing on the oversight, management and continuous improvement of vendor partner performance based on established best practices and program service level agreements.. Key Responsibilities - To simplify complexities for each customer. Demonstrates the ability to analyze and report program results in order to detect trends, identify issues, and opportunities.  Providing vendors with recommendations and when necessary implement action plans for performance improvement.. Performs due diligence... view job details

Summary. Responsible for provisioning, installation, configuration, operation, and maintenance of systems hardware, software and related infrastructure in an enterprise environment. Key Responsibilities - To simplify complexities for each customer. Customer Service. Respond to requests for assistance within established SLAs. Participate in after-hours, on-call support rotation. System Administration. Collaborate across IT functional teams to resolve complex issues or assigned tasks as well as design, evaluate, implement, and maintain approved modifications to systems and services. Perform dail... view job details

Summary. The learning consultant is responsible for supporting internal business partners by assessing needs and designing, developing, delivering, maintaining and evaluating continuous learning programs for both internal (and external as needed) learners in support of a variety of business initiatives.. Key Responsibilities - To simplify complexities for each customer. Analyzes training needs and develops programs that maximize knowledge transfer by aligning recognized best practices of instructional theory with business strategies. Collaborates with technical and operational team members to ... view job details

Summary. Manage and maintain communications and information to clients and/or vendors; this includes clerical and administrative duties, planning, scheduling, office organization, research, and information handling as required. Support to both Referral and Billing Teams by administering responsibility related to daily creation of each team’s incoming Client/Vendor requests and input into ticketing system.. Key Responsibilities - To simplify complexities for each customer. Effectively utilize proprietary, industry specific and general MS Office software to support the needs of the department (i... view job details

Summary. The Operations Support Specialist provides operational support for the users of Healthesystems systems and services.   This includes customers, external vendor partners and internal stakeholders.  They will perform a variety of operational tasks assigned by their supervisor/manager that will assist with the support and maintenance of the system(s).. Key Responsibilities - To simplify complexities for each customer. Perform operational tasks related to customer and vendor support and maintenance of the system (as assigned by supervisor/manager).. Research, resolve and/or escalate incom... view job details

Summary. Key accounting role with a midsized employer voted Tampa Bay’s Best Places To Work.  Collecting and reviewing employee information and working hours, calculating wages, preparing and processing payroll, maintaining accurate payroll records, preparing payroll related month end journal entries and accruals, and account reconciliations.  Supports the financial and internal audits as needed.   The ideal candidate needs to be able to work well independently, have effective time management skills, and have good customer service skills.. Key Responsibilities - To simplify complexities for ea... view job details