- 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 ...regarding complex or sensitive issues or regulations.Strong experience with Medicare health care products preferred.Knowledge and experience… more
- Segal (Boston, MA)
- …Act, Public Health Service Act and related health legislation and regulations, Medicare , Medicare Part D , and Medicare Advantage Programs, ... The Opportunity:We seek an experienced ERISA and employee benefits health plan lawyer who is interested in pursuing a challenging and growth-oriented consulting… more
- ConsultNet (North Kingstown, RI)
- …a complex, inbound 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 Medicare Part D and Commercial...of service to Medicare Part D and Commercial PBM members and...to three years of experience in the PBM or health plan pharmacy space Candidate should have working knowledge… 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 ... health care delivery, from private marketplaces and employer-sponsored insurance to Medicare and Medicaid; from large health care systems to small clinics;… more
- GEHA (Lee's Summit, MO)
- …a personalized customer experience, sustained by a nimble and efficient organization. The Medicare Part D Performance Management Specialist will report to ... GEHA (Government Employees Health Association, Inc., pronounced GEHA) is a nonprofit...for monitoring contractual, operational, reporting, and regulatory requirements for Medicare Part D / EGWP… 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...and Blue Shield of North Carolina (Blue Cross NC). Health care is changing, and we're leading the way.… more
- Healthfirst (NY)
- … Medicare Clinical Programming and Operations, Provider Performance, Medical and Pharmacy Part D cost savings, and Medicare Star Ratings/member ... finance, clinical, medical economics, operations, risk adjustment, and population health strategy to implement Medicare strategies and...and Operations + Provider performance + Medical and Pharmacy Part D cost savings + Medicare… more
- CVS Health (Blue Bell, PA)
- …+ Solid technical/analytical skills and attention to detail Preferred Qualifications + Previous Pharmacy, Medicare Part D , Medicare experience + ASA or ... Bring your heart to CVS Health . Every one of us at CVS ...financial and business impacts of changes to the complex Part D market and completive landscape. The… 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 ... Actuarial team members to enhance actuarial knowledge + Monitor the Health Policy environment considering the implication of organization pricing policies, law,… more
- VNS Health (Manhattan, NY)
- … Plans product lines - Managed Long Term Care (MLTC), Medicare Advantage (MA), Part D , or Select Health to ensure compliance with mandated regulatory ... Plans product lines - Managed Long Term Care (MLTC), Medicare Advantage (MA) or Select Health . Ensures...in the home and community. When you join VNS Health , you become a part of something… more
- Centene Corporation (Phoenix, AZ)
- … Medicare Part D / Part B, Appeals, Medicare Part D Operations and State Health Programs Pharmacy Operations or Prior Authorization. Using ... million members as a clinical professional on our Medical Management/ Health Services team. Centene is a diversified, national organization...Regional Medical Director on related issues. + Prior Authorization Medicare Part D and … 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.... 4 - 5 years of experience in a health plan, pharmacy, or PBM operations, which includes exposure… more
- Walworth County (Elkhorn, WI)
- …This position is responsible for assisting Medicare beneficiaries with enrollment issues regarding Medicare Part D , Medicare Part C (Advantage ... Elkhorn, WI Job Type Casual Job Number 2021-00139 Department Health & Human Services Division Aging & Disability Resource...or restrict the tasks that may be assigned. Perform Medicare Part D drug assessments… more
- CVS Health (Harrisburg, PA)
- …Managed Care experience in health plan and/or PBM roles 15+ years Medicare experience **Education** Pharmacist, BS or Pharm D with active, unrestricted ... formulation, implementation and milestone tracking for business plans as Part of the Medicare benefit and product...**Required Qualifications** 10+ years of Managed Care experience in health plan and/or PBM roles 10+ years Medicare… more
- CVS Health (Chicago, IL)
- …working in a fast-paced environment with constant change Preferred Qualifications + Prior Pharmacy, Medicare Part D , Medicare or Medicaid experience + ... and affordable. Join a high-performing actuarial team supporting CVS Health and Aetna's Government Services Medicare Advantage...position will provide modelling and analytical support for the Part D Business, with a focus on… more
- CVS Health (Chicago, IL)
- …PDP Products. This role will focus on developing health care solutions for Medicare Part D members. The colleague provides actuarial support to ensure ... Bring your heart to CVS Health . Every one of us at CVS ...attention to detail Preferred Qualifications + Previous Pharmacy or Medicare Part D experience +… more
- Northwell Health (Westbury, NY)
- …Job Description Seeking RN - BSN or MSN candidates with a HCS- D - Home Care Coding Specialist-Diagnosis, COS-C Certificate for OASIS Specialist-Clinical. Conducts ... Home Health Resource Group (HHRG) Validation to ensure the diagnostic...the Medical Record. Job Responsibility + Audits and reviews Medicare /non- Medicare charts to ensure that proper standards… 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)
- **Job Description:** As an RPh Advisor you will be directly supporting Medicare Part D members and providers with requests related to their pharmacy ... and timelines. Reviewing information and completing timely and accurate documentation of all Medicare Part D requests, in compliance with Medicare… more
- Central Maine Medical Center (Lewiston, ME)
- …staff and other department managers.c) Creates and sustains a culture of safety. d ) Leads and manages change effectively.e) Responds to change productively, promotes ... and behavior.k) Maintains awareness of professional standards for Nursing, ongoing health care policies and economics, maintains awareness of future trends and… more
