- ConsultNet (North Kingstown, RI)
- …that may impact them or their customers Be a subject matter expert on PBM and Medicare Part D business ; explain processes, protocols, benefits, services ... Customer Care center. Customer Care Manager, Rx will focus on supporting our Medicare Part D and PBM business by providing a complex level of service to … more
- Cambia Health Solutions, Inc (Portland, OR)
- …activities.Directs activities necessary to assure compliant operation of Medicare Advantage and Medicare Part D contracts as well as MediGap products ... To develop and oversee compliance with Medicare Part C and Part D ...and managed care program requirements, with an emphasis on Medicare health care laws and regulations.Conducts business … more
- U of C NORC (Bethesda, MD)
- …quality outcomes using relevant administrative data sets such as Medicare Advantage, Medicare Part D , Medicaid data as well as commercial dataResearch ... of health care delivery, from private marketplaces and employer-sponsored insurance to Medicare and Medicaid; from large health care systems to small clinics; and… more
- Segal (Boston, MA)
- …and Medical Leave Act, Public Health Service Act and related health legislation and regulations, Medicare , Medicare Part D , and Medicare Advantage ... in legislation/ regulation and other technical issues.Supporting marketing and business -development initiative to grow revenue and profitability.Key Requirements:J. D… more
- US Tech Solutions, Inc. (Chandler, AZ)
- …as well as the able to work as part of a team Knowledge of Medicare Part D beneficial, but not required Education: Verifiable High School Diploma or ... GED is required. Bachelors degree in finance, accounting or business is preferred. more
- GEHA (Lee's Summit, MO)
- …operational, reporting, and regulatory requirements for Medicare Part D / EGWP lines of business . **SKILLS** **Responsibilities:** + Serves as ... experience, sustained by a nimble and efficient organization. The Medicare Part D Performance Management...Pharmacy to align Medicare Part D / EGWP lines of business to… more
- KPH Healthcare Services, Inc. (East Syracuse, NY)
- **Overview** **The selected candidate must have** **5+ years experience in Medicare Part D and/or EGWP programs.** **Scope of Responsibilities:** Provides ... oversight and management of Medicare Part D /EGWP program. **Job...client benefit. Aid internal teams to support clients and business partners. **Responsibilities** + Provide oversight of operational activities… more
- BlueCross BlueShield of North Carolina (NC)
- **Job Description** This Consulting Actuary with a Medicare Part D focus on the Medicare Pricing team, will provide pricing, forecasting, and strategic ... Medicare products with a particular emphasis on Medicare Part D . You will...evaluate risks and strategic opportunities involving Blue Cross NC's Medicare business through the deployment of actuarial… more
- Healthfirst (NY)
- … Medicare Clinical Programming and Operations, Provider Performance, Medical and Pharmacy Part D cost savings, and Medicare Star Ratings/member ... areas of performance improvement opportunity and to make informed business decisions. + Leverages market and competitive intelligence reporting...and Operations + Provider performance + Medical and Pharmacy Part D cost savings + Medicare… more
- CVS Health (Blue Bell, PA)
- …market and completive landscape. The position will provide analytical and reporting support for the Part D Business , with a focus on pricing, modelling, and ... . This role will focus on analyzing financial and business impacts of changes to the complex Part...and attention to detail Preferred Qualifications + Previous Pharmacy, Medicare Part D , Medicare… 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 ... concepts, and provide pricing support for all lines of business . This position will also lead complex projects that...healthcare organization or PBM + Previous experience pricing Commercial, Medicare or Medicaid lines of businesses + 5 years… more
- Medical Mutual of Ohio (OH)
- …general supervision, administers standardized to moderately complex daily operations in compliance with the Medicare Part D (pharmacy) and Medicare ... in internal and external audits and projects of the Medicare Part D (pharmacy) and...Medicare Pharmacy Coordinator I** . Associate Degree in Business Administration, Healthcare, or related field or equivalent combination… more
- The Cigna Group (Nashville, TN)
- …Network Operations. + Responsible for analysis and interpretation of moderate to complex Medicare Part C and D financial information. Utilizes independent ... Officer (BFO), supporting the Midwest and MidAmerica markets of our Medicare Advantage business . We are seeking a creative and strategic finance leader capable… more
- CVS Health (Chicago, IL)
- …SNP and PDP Products. This role will focus on developing health care solutions for Medicare Part D members. The colleague provides actuarial support to ... ensure business strategy achieve optimal outcomes within the ...attention to detail Preferred Qualifications + Previous Pharmacy or Medicare Part D experience +… more
- CVS Health (Harrisburg, PA)
- …Directs the formulation, implementation and milestone tracking for business plans as Part of the Medicare benefit and product cycle. Directs the strategic ... years of Managed Care experience in health plan and/or PBM roles 15+ years Medicare experience **Education** Pharmacist, BS or Pharm D with active, unrestricted… more
- CVS Health (Chicago, IL)
- …Drug Plan business . The position will provide modelling and analytical support for the Part D Business , with a focus on pricing, modelling, and bid ... technical skills and critical thinking to design and achieve business solutions + Demonstrate understanding of existing data sources...environment with constant change Preferred Qualifications + Prior Pharmacy, Medicare Part D , Medicare… more
- UCLA Health (Los Angeles, CA)
- …Healthcare, or a related field required. + Five or more years of experience in a Medicare Advantage and Part D Managed Care compliance role is required. + ... processes that maintain essential elements of our compliance efforts within the Medicare Advantage program. In this role, you'll oversee policy and procedure… more
- US Tech Solutions (May, OK)
- …requests for multiple clients or lines of business and in accordance with Medicare Part D CMS Regulations. + Must apply information provided through ... requires schedule flexibility and additional cross training to learn all lines of business . + Flexibility for movement to different parts of the business … more
- InnovaCare (San Juan, PR)
- …members, during and after natural disasters. Through the Florida MMM Line of Care, as a Part D sponsor, you will ensure that the member has adequate access to ... a conglomerate of companies that work on Puerto Rico's business strategies, both for Medicare Advantage beneficiaries,...their covered Part D drugs. Orlando Family Physicians, a… more
- InnovaCare (Guayama, PR)
- …members, during and after natural disasters. Through the Florida MMM Line of Care, as a Part D sponsor, you will ensure that the member has adequate access to ... a conglomerate of companies that work on Puerto Rico's business strategies, both for Medicare Advantage beneficiaries,...their covered Part D drugs. Orlando Family Physicians, a… more
