- Merck & Co. (North Wales, PA)
- …management accountsLTCNational and regional health plans and PBMs (Commercial, Managed Medicaid, Medicare Part D )The US Market Access Contracting Team ... acts as a unique and critical connection point in a dynamic environment to bridge field and internal stakeholders for the purpose of reaching mutually beneficial customer contracts. In close partnership with IAM Field Teams, Payer Marketing, and other key… more
- Insmed Incorporated (Los Angeles, CA)
- …preferred Product launch experience preferred Experience navigating payer reimbursement process, preferably Medicare Part D (pharmacy benefit design and ... and vision plansCompany-provided Life and Accidental Death & Dismemberment (AD& D ) insuranceCompany-provided short and long-term disability benefitsUnique offerings of… 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 ... responsible for monitoring contractual, operational, reporting, and regulatory requirements for Medicare Part D / EGWP lines of business. **SKILLS**… 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 Summary:** The position will be the operational subject matter expert for administration of… 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 ... all Blue Cross NC Medicare products with a particular emphasis on Medicare Part D . You will identify and evaluate risks and strategic opportunities… 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 ... on analyzing financial and business impacts of changes to the complex Part D market and completive landscape. The position will provide analytical and reporting… 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...a disability and need a reasonable accommodation for any part of the employment process, please contact Human Resources… more
- Healthfirst (NY)
- … Medicare Clinical Programming and Operations, Provider Performance, Medical and Pharmacy Part D cost savings, and Medicare Star Ratings/member ... Clinical Programming and Operations + Provider performance + Medical and Pharmacy Part D cost savings + Medicare Star Ratings/member experience. **Compliance… 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 ... material requirements. . Assists in internal and external audits and projects of the Medicare Part D (pharmacy) and Part C (medical drug) programs as… more
- Walworth County (Elkhorn, WI)
- …This position is responsible for assisting Medicare beneficiaries with enrollment issues regarding Medicare Part D , Medicare Part C (Advantage ... it does not prescribe or restrict the tasks that may be assigned. Perform Medicare Part D drug assessments by entering consumer's drug information into the… 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 + ... actuarial team supporting CVS Health and Aetna's Government Services Medicare Advantage and Prescription Drug Plan business. The position...position will provide modelling and analytical support for the Part D Business, with a focus on… 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 ... skills and attention to detail Preferred Qualifications + Previous Pharmacy or Medicare Part D experience + FSA designation + Experience with SAS,… 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 ... timelines. Reviewing information and completing timely and accurate documentation of all Medicare Part D requests, in compliance with Medicare … more
- US Tech Solutions (May, OK)
- …exception requests for multiple clients or lines of business and in accordance with Medicare Part D CMS Regulations. + Must apply information provided ... where needed. **Responsibilities:** + Utilizing multiple software systems to complete Medicare appeals case reviews + Meeting or exceeding government mandated… 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
- 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 ... (BFO), supporting the Midwest and MidAmerica markets of our Medicare Advantage business. We are seeking a creative and...able to lead and delegate responsibilities as needed + Medicare Advantage experience and general knowledge of the healthcare… more
- Prime Therapeutics (Columbus, OH)
- …information, responding to questions and resolving complex problems and issues. + If supporting Medicare Part D , will be responsible for implementing CMS ... + 3+ years of Big 4 public accounting experience. + For roles supporting Medicare Part D : Medicare , PBM and/or managed care experience preferred. +… more
- CVS Health (Columbus, OH)
- …to support analytics - Quantifying the impact of legislative and regulatory changes in the Medicare Part D landscape - Developing various ad hoc analyses for ... data analyzing pharmacy claims or other relevant data analysis * Experience with Medicare Part D , Medicare Advantage, or Medicaid * Intimate knowledge… 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 ... by reviewing information and completing timely and accurate documentation of all Medicare Part D requests, in compliance with Medicare guidelines,… more
- Adecco US, Inc. (Houston, TX)
- …$28.90 to $ 30.90/hr **Responsibilities:** . Serve as dedicated resource to multiple complex Medicare Part D plans to manage first level response and ... direct contact via phone, email . Understand the overall business model of Medicare Part D products, CMS guidance, the Pharmacy Benefit Manager (PBM) claim… more
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