- Daiichi Sankyo, Inc. (Bernards, NJ)
- …but not limited to, areas of GPO/PBM and trade/distribution agreements, Medicare , Medicaid, product pricing, and government price reporting. Coordination with, and ... Lead drafting and negotiating contracts for commercial, Medicaid and Medicare coverage, as well as other government contracts, trade/distribution agreements,… more
- Merck & Co. (North Wales, PA)
- …Integrated Delivery Networks, Hospital Systems, Group Purchasing Organizations, Federal agencies, Pharmacy/Wholesalers, and Infusion companies for our Company's ... and implement the contract strategies for the following customer segments: Federal (Medicaid, 340B, Apexus, DoD, VA)GPOHospitals and hospital systemsInfusion and… more
- Eisai, Inc (Boston, MA)
- …strong understanding of the US healthcare system across major payer segments ( Medicare , Medicaid, Federal , and Commercial) Strong understanding of medical and ... Customers: Market Access, Marketing Teams, Government Relations, Legal and Compliance Key External Customers: Health Care Professionals and stakeholders responsible… more
- USAA (San Antonio, TX)
- …Medicare Supplement and Medicare product management. + Working experience with Medicare State and Federal Regulations + Working knowledge Medicare ... currently seeking a talented **Business Process Owner I** that will support Medicare Supplement Claims for USAA Life Company Claims Operations. This employee will… more
- Healthfirst (NY)
- …Provider performance + Medical and Pharmacy Part D cost savings + Medicare Star Ratings/member experience. ** Compliance & Regulatory Responsibilities:** Noted ... on all aspects related to one or more specific Medicare performance areas such as Risk Score Accuracy, ...status, mental or physical disability or any other protected Federal , State/Province or Local status unrelated to the performance… more
- CVS Health (Nashville, TN)
- …talent! We have an exciting opportunity available for highly motivated individuals as Medicare Sales Specialist. The position will be a part of a specialized team ... who will focus on educating existing Medicare members on available plan offerings to help meet...selling applicable products to existing members. + Maintaining high compliance commitment and standards with a robust knowledge with… more
- Providence (OR)
- …to optimize performance + Analyzing and interpreting regulatory guidance to ensure compliance with Medicare Advantage bid requirements + Collaborating with ... empower them._** **Providence Health Plan is calling a Senior Actuarial Analyst, Medicare Bid who will:** + Be responsible for developing and maintaining actuarial… more
- KPH Healthcare Services, Inc. (East Syracuse, NY)
- …and business partners. **Responsibilities** + Provide oversight of operational activities of Medicare Part D/EGWP programs + Ensure compliance with CMS rules ... **Overview** **The selected candidate must have** **5+ years experience in Medicare Part D and/or EGWP programs.** **Scope of Responsibilities:** Provides oversight… more
- Dana-Farber Cancer Institute (Brookline, MA)
- …of research activity in an academic medical center + Knowledge of billing compliance and Medicare regulations/policy, applicable federal , state, and local ... including federal and state regulations. + Applies clinical guidelines, Medicare regulations, and study team guidance of conventional care to independently… more
- Humana (Columbus, OH)
- …service should be authorized. All work occurs with a context of regulatory compliance , and work is assisted by diverse resources, which may include national clinical ... teaching conferences, and other sources of expertise. Medical Directors will learn Medicare and Medicare Advantage requirements, and will understand how to… more
- Humana (Columbus, OH)
- …service should be authorized. All work occurs within a context of regulatory compliance and work is assisted by diverse resources which may include national clinical ... other sources of expertise. The Behavioral Health Medical Directors will learn Medicare , Medicare Advantage and/or Medicaid requirements, and will understand how… more
- CVS Health (Harrisburg, PA)
- …implementation and milestone tracking for business plans as Part of the Medicare benefit and product cycle. Directs the strategic development and implementation of ... large product initiatives, including new products and product enhancements for Medicare formularies, UM and clinical tools for Medicare PDP, MAPD and employer… more
- Humana (Columbus, OH)
- …our caring community and help us put health first** The Group Medicare Proposal Development/Contract Review Professional 2 reviews solicitations and prepares routine ... simple requests for proposals (RFPs)/request for renewals (RFRs). The Group Medicare Proposal Development/Contract Review Professional 2 is primarily responsible for… more
- Kelly Services (Port Neches, TX)
- ** Medicare Agent** **Location:** Beaumont, TX + Remote **Employment Type:** Full-Time / Part-Time **Salary:** Depending on experience + Commission **Key ... Responsibilities:** + **Client Consultations:** Understand clients' needs and explain Medicare options + **Plan Recommendations:** Compare and recommend Medicare … more
- Somatus (Mclean, VA)
- … for risk score accuracy. + Responsible for the program to meet full compliance with state, federal and partner requirements. + Drives industry best practices ... well-being + Community engagement opportunities + And more! The Sr. Director, Medicare Risk Adjustment (MRA) will lead the execution strategy and implementation of… more
- Healthfirst (NY)
- …agency + Knowledgeable of Department of Health (DOH) and Center for Medicare & Medicaid Services (CMS) regulations ** Compliance & Regulatory Responsibilities:** ... the enabling tools and technology (software and hardware) that support the Medicare Sales Operations team Works with internal and external constituents as applicable… more
- CVS Health (Salt Lake City, UT)
- …for ensuring broker adherence to all CMS and Aetna guidelines by monitoring compliance with state, federal , and health plan regulatory requirements. - Maintains ... care more personal, convenient and affordable. **Position Summary** Aetna is looking for a Medicare Sales Broker Manager to join the Utah sales team who will drive… more
- Travelers Insurance Company (Columbus, OH)
- …strategies for addressing and resolving various types of debt, including Medicare , to deliver positive financial outcomes. This role requires leveraging economic ... including lien analysis and Conditional Payments. This leader also supervises compliance and reporting duties as a Registered Reporting Entity for Travelers… more
- Healthfirst (NY)
- + Direct all prospect and sales activities for Medicare products for a specified geographic area. + Develop and Implementing strategies and policies relating to ... Medicare sales and service. + Ensure interpersonal effectiveness among...resolve any outstanding issues. + Ensure sales staff maintains compliance with all CMS /corporate policies and regulations. Work… more
- CVS Health (Tallahassee, FL)
- …help prospects navigate through our website as well as answer questions regarding Medicare eligibility and benefits. Guide prospects on how to self enroll. Complete ... navigation. Valid license to sell healthcare plans. Minimum of 2 years selling Medicare plans in a telesales environment. Ability to pass AHIP exam on an… more
