- KPH Healthcare Services, Inc. (East Syracuse, NY)
- …minimum wage requirements. Connect With Us! (https://kphcareers-kphhealthcareservices.icims.com/jobs/12697/ manager -of- medicare - part - d ... **Overview** **The selected candidate must have** **5+ years experience in Medicare Part D and/or EGWP programs.** **Scope of Responsibilities:** Provides… more
- Medical Mutual of Ohio (OH)
- …a fully remote opportunity_** . **_Eastern & Central Time Zones preferred. Extensive Medicare Part D experience is highly sought after._** ... to moderately complex daily operations in compliance with the Medicare Part D (pharmacy) and...focus on member experience. Conducts outreach to Pharmacy Benefit Manager (PBM) for refills, claim reprocessing and to members… more
- Medical Mutual of Ohio (Brooklyn, OH)
- …relevant work experience required with at least 2 years directly involved in Medicare Advantage or Part D auditing activities. **Professional Certification** ... Compliance Program and all compliance-related activities for the Company's Medicare Advantage ( Part C) and Prescription Drug... Advantage ( Part C) and Prescription Drug ( Part D ) health plan programs. Ensures that… more
- Elevance Health (Columbus, OH)
- … members. -Understanding of the benefit design and formularies, specifically for Part D . -Experience in a pharmacy benefit management organization leading ... pharmacy care. In this pivotal role on our CarelonRx Medicare Sales and Account Management team, the Pharmacy Account...understanding of the intricate workings of a pharmacy benefit manager . Ideal incumbents are likely to be proficient clinicians… more
- Elevance Health (Atlanta, GA)
- …regulations for program areas including but not limited to: claims, grievances and appeals, Part D and risk adjustment. + Knowledge of Risk Adjustment Payment ... objectives. + Collaborates with management to set strategic vision; oversees manager (s)/director(s) with direct reports. + Hires, trains, coaches, counsels, and… more
- G-TECH Services, Inc. (Detroit, MI)
- …* Assist with all functions related to Pharmacy Benefit Manager (PBM) oversight for Medicare Advantage Part D plans. * Receive and respond to plan ... and prescription drug names Required Skills * Working knowledge of Medicare Part B and Part D * Ability to plan, organize, direct, and control projects.… more
- AdventHealth (Rome, GA)
- **_Description -External_** **OR Nurse Manager ** **All the benefits and perks you need for you and your family:** + Benefits from Day One + Paid Days Off from Day ... **Our promise to you:** Joining AdventHealth is about being part of something bigger. It's about belonging to a...of patient care services, including but not limited to Medicare , Managed care, Medicaid, third-party providers, challenges to current… more
- Convey Health Solutions (Fort Lauderdale, FL)
- …* Experience in a Medicare Advantage healthcare operations environment working with Medicare Part D (preferred). Knowledge, Skills, and Abilities * ... to drive effective change. A subject matter expert in Medicare processes, the manager ensures services align...engagement activities to include wellness sponsored events are a part of our inclusive and diverse culture Equal Opportunity… more
- CVS Health (Blue Bell, PA)
- …make health care more personal, convenient and affordable. **Position Summary:** Join the Aetna Medicare Part D Actuarial Team as the enterprise embarks on ... computing to streamline and modernize Aetna's Part D rating systems. As Senior Manager of...the creation of tools and models used by Aetna's Medicare Part D pricing processes… more
- BrightSpring Health Services (Louisville, KY)
- …MOR, Sales, Key Strategic Operational changes, etc. + Assist with Member reconciliation, Part D Recon, LIS tracking, Rebate tracking, Claim subrogation, and ... support the Medicare Advantage Institutional Special Needs Plan (I-SNP), the Manager will work in collaboration with all clinical and operations staff on varying… more
- VNS Health (Manhattan, NY)
- …one of the following VNS Health Plans product lines - Managed Long Term Care (MLTC), Medicare Advantage (MA), Part D , or Select Health to ensure compliance ... of healthcare? VNS Health Plans is seeking a dedicated Manager , Grievance and Appeals (RN)to lead the daily operations...and appeals across our Managed Long Term Care (MLTC), Medicare Advantage (MA), or Select Health product lines. *… more
- Sanofi Group (Cambridge, MA)
- …to get started? **Main responsibilities:** + Responsible for the management and development of Medicare Part D , Managed Medicaid, and Commercial health plan ... financial goals. + Detailed understanding, review and negotiating of contract language for Medicare Part D , Managed Medicaid, and Commercial health plan… more
- ACI Federal (Norfolk, VA)
- …will form the performance criteria for the annual performance evaluation. Full-Time/ Part -Time Full-Time Position Non-Medical Case Manager Position Requirements ... Case Manager - CM III ITCN EOE Statement We...for HIPAA, mandated reporting of abuse and/or neglect, Client Rights/ Part C Procedural Safeguards and Client Confidentiality. 5. Complies… more
- ACI Federal (Norfolk, VA)
- …add or remove duties and assign other duties as necessary. Full-Time/ Part -Time Full-Time Position Non-Medical Case Manager Position Requirements Knowledge, ... Case Manager - CM III PATH EOE Statement We...settings including clinical and field. Ability to work as part of a team; respond to inquiries in a… more
- Banner Health (AZ)
- …annual website update, marketing materials, LIS match Rates, Monthly Encounter Data (formerly RAPS), Part C and Part D Reporting. 5. Provides support for ... Plans & Networks (BPN) is a nationally recognized healthcare leader that integrates Medicare and private health plans. Our main goal is to reduce healthcare costs… more
- The County of Los Angeles (Los Angeles, CA)
- MENTAL HEALTH PROGRAM MANAGER II / EMERGENCY APPOINTMENTS HOMELESSNESS Print (https://www.governmentjobs.com/careers/lacounty/jobs/newprint/4659662) Apply MENTAL ... HEALTH PROGRAM MANAGER II / EMERGENCY APPOINTMENTS HOMELESSNESS Salary $132,439.68 -...concerning program administration, ensuring compliance with Federal and State Medicare and Medicaid regulations for reimbursement claiming and maximum… more
- Lumeris (IL)
- …Thank you for your interest in Lumeris. **Position:** Population Health Manager **Position Summary:** Responsible for improving Accountable Care Team (Provider) ... + Demonstrated subject matter expertise in any of the following areas: Medicare advantage, Medicare Shared Savings Program (MSSP), managed care regulations,… more
- Molina Healthcare (Houston, TX)
- …of Houston, TX to join Molina as a Case Manager working with our Medicare members. Part of the responsibilities of the role is to conduct face-to-face ... those candidates with previous LTSS experience as the Case Manager will support both waiver and non-waiver members. Mileage...both waiver and non-waiver members. Mileage is reimbursed as part of our benefits package. Hours are Monday -… more
- The County of Los Angeles (Los Angeles, CA)
- HEALTH FACILITIES PROGRAM MANAGER Print (https://www.governmentjobs.com/careers/lacounty/jobs/newprint/4674812) Apply HEALTH FACILITIES PROGRAM MANAGER Salary ... enforcement actions for the Division, including processing license revocations, Medicare and Medi-Cal decertifications and criminal complaints and provides technical… more
- BeiGene (Jefferson City, MO)
- …managed markets, hospital markets, various sites of care, IV medications, injectables, orals and Medicare Part D , etc. + Ability to measure and analyze ... **General Description:** Reporting to the Division Sales Manager , The Account Manager - Hematology will contribute to BeiGene's overall sales objective by… more