- Cambia Health Solutions, Inc (Portland, OR)
- Director Government Programs Compliance Officer Work a Hybrid...assure compliant operation of Medicare Advantage and Medicare Part D contracts as ... Are Looking For: Every day, Cambia's dedicated team of Director Government Programs Compliance Officer is living our mission...To develop and oversee compliance with Medicare Part C and Part D … more
- Staffing Now (OK)
- …to staffServe as a subject-matter expert for direct reports in the areas of Part C, Part D , Medicare Parts A & B, Medicare claims billing, and ... The Quality Assurance Specialist reports to the Director of Customer CareIn this role you will...of two (2) years of member services experience, in Medicare Advantage Minimum of one (1) year of experience… more
- GEHA (Lee's Summit, MO)
- …+ Work in conjunction with the Vice President and Director of Pharmacy to align Medicare Part D / EGWP lines of business to organizational goals and ... experience, sustained by a nimble and efficient organization. The Medicare Part D Performance Management...D Performance Management Specialist will report to the Director of Pharmacy and will be responsible for monitoring… more
- Prime Therapeutics (Columbus, OH)
- …our passion and drives every decision we make. **Job Posting Title** Principal Actuary - Medicare Part D - Remote **Job Description** The Principal Actuary ... healthcare organization or PBM + Previous experience pricing Commercial, Medicare or Medicaid lines of businesses + 5 years...**Reporting Structure** + Reports to Senior Principal or Senior Director in the Finance department Potential pay for this… more
- CVS Health (Harrisburg, PA)
- …Summary** Directs the formulation, implementation and milestone tracking for business plans as Part of the Medicare benefit and product cycle. Directs the ... experience in health plan and/or PBM roles 15+ years Medicare experience **Education** Pharmacist, BS or Pharm D... Medicare experience **Education** Pharmacist, BS or Pharm D with active, unrestricted license in good standing **Pay… more
- Central Maine Medical Center (Lewiston, ME)
- …and for each other every day. Position Summary: Reporting to the Nursing Director , the Nurse Leader is responsible for the day-to-day operations of assigned ... evaluating the operation of their assigned department. In conjunction with the Director , the Nurse Leader is responsible for overseeing implementation of patient… more
- Marshfield Clinic (Eau Claire, WI)
- …communication with referral network across system; work with regional specialty director (s) to address deficiencies d . Identify new services/service expansion; ... in the world!** **Job Title:** Assistant Service Line Medical Director - Hematology/Oncology **Cost Center:** 301081251 Systems Operations **Scheduled Weekly… more
- Molina Healthcare (Starkville, MS)
- …and local laws and regulatory requirements affecting the medical and clinical staff. + Part Time Perinatal Medical Director , Based in MS **Job Duties** + ... improvement activity (QIA) in collaboration with the clinical lead, the medical director , and quality improvement staff. + Facilitates conformance to Medicare ,… more
- CareOregon (Portland, OR)
- …focus on achieving better quality of care for a special needs, dually eligible Medicare population by understanding and applying D -SNP Medicare regulatory ... Job Title Medical Director - Clinical Services Department Medical Management Administration...Aim. Direct support may be focused on Medicaid or Medicare lines of business in a Coordinated Care Organization… more
- Prime Therapeutics (Eagan, MN)
- …for new and emerging Government program projects related to Medicare , Medicaid, and Medicare Part D . + Finance lead for key government program ... drives every decision we make. **Job Posting Title** Finance Director - Government Programs - Remote **Job Description** The...initiatives including premium billing and Medicare Part D reporting and… more
- Molina Healthcare (Starkville, MS)
- …Psychiatry **REQUIRED EXPERIENCE:** * 2 years previous experience as a Medical Director in clinical practice * 3 years' experience in Utilization/Quality Program ... State **(MS)** Medical License, free of sanctions from Medicaid or Medicare . **Preferred Experience** * Peer Review, medical policy/procedure development, provider… more
- CareFirst (Baltimore, MD)
- …activities. + Experience with developing and implementing clinical programs. + Experience with Medicare Part D and Medicaid guidelines and requirements. + ... **Resp & Qualifications** **PURPOSE:** Director , Pharmacy Government Programs is responsible for implementing...organization's pharmacy vision and strategic plan for government programs ( Medicare and Medicaid). This role has oversight of pharmacy… more
- HCA Healthcare (Nashville, TN)
- …you want to join an organization that invests in you as a Senior Director Regulatory and Accreditation? At HCA Healthcare, you come first. HCA Healthcare has ... Fund that offers free employee-only coverage to full-time and part -time colleagues based on income. Learn more about Employee...a difference. We are looking for a dedicated Senior Director Regulatory and Accreditation like you to be a… more
- Merck (North Wales, PA)
- …accounts + LTC + National and regional health plans and PBMs (Commercial, Managed Medicaid, Medicare Part D ) The US Market Access Contracting Team acts as ... **Job Description** The Director , US Market Access Contracting sits within the National Contract Operations and Supply Chain Team (NCOSC), which delivers… more
- Option Care Health (Peachtree Corners, GA)
- …Understanding of billing and reimbursement procedures for medical offices and hospitals (Commercial Insurance, Medicare Part B & D , Fee for Service Medicaid, ... a two-year recipient of the Gallup Exceptional Workplace Award, we recognize that part of being extraordinary is building a **thriving workforce that is as diverse… more
- Centene Corporation (Phoenix, AZ)
- …with Clinical Pharmacists or Regional Medical Director on related issues. + Prior Authorization Medicare Part D and Part B + Tracks and triage ... of the following areas: Formulary Management, Pharmacy Audit and Recovery, Pharmacy Service Center, Medicare Part D / Part B, Appeals, Medicare Part… more
- Trinity Health (Philadelphia, PA)
- …with the Medical Director . + Ensure compliance with CMS regulations and manage Medicare Part D fraud, waste, and abuse programs. + Lead quality ... **Employment Type:** Full time **Shift:** **Description:** ** Director of Quality Improvement and Compliance** **Ministry Name:...communication skills. + Ability to work independently and as part of a collaborative team. + Proficiency in Microsoft… more
- Arvinas (New Haven, CT)
- …(HIPAA regulations), product reimbursement and product access. + Knowledge and experience in Medicare Part A- D , Medicaid, and private payer policies, ... member of the Market Access Leadership team, the Senior Director , US Pricing & Contracting Strategy will lead the...Benefit Design & Economics associated with Commercial, Medicaid and Medicare reimbursement for oral drugs with Oncology Customers +… more
- State of Indiana (Richmond, IN)
- Clinical Director Date Posted: Sep 12, 2024 Requisition ID: 449523 Location: Richmond, IN, US, 47374 Work for Indiana Begin a fulfilling career with the State of ... Family and Social Services Administration Division of Mental Health and Addiction. As part of a newly integrated system of state psychiatric hospitals, we serve… more
- Lumeris (IL)
- …information. Thank you for your interest in Lumeris. **Position:** Director Physician Partner Operations **Position Summary:** Oversees delivery management for ... in Health Administration, or similar degree + Experience in managed care and/or Medicare Advantage **Working Conditions** + While performing the duties of this job,… more
