- Tris Pharma (Monmouth Junction, NJ)
- …working knowledge of government pricing regulations including MDRP (Medicaid Drug Rebate Program), Medicare Part D , 340B, and VA Federal Supply Schedule; ... and State programs including MDRP (Medicaid Drug Rebate Program), Medicare Parts B and D , Public Health...Drug Rebate Program), Medicare Parts B and D , Public Health Service/340B, and VA Federal Supply ScheduleCollaborates… more
- Abt Global Inc. (Rockville, MD)
- …overseeing complex data analysis projects. + At least 5 years of experience working with Medicare , including Part D and Medicare Advantage, and Medicaid ... involving diverse government stakeholders. + Ensure alignment of project goals with Medicare and Medicaid program and payment policy frameworks. **What We Value** +… more
- BeOne Medicines (Emeryville, CA)
- …managed markets, hospital markets, various sites of care, IV medications, injectables, orals and Medicare Part D , etc. + Ability to measure and analyze ... key performance indicators (ROI and KPIs). + Familiarity with CRM software and proven track record of use. + Ability to actively engage in developing new business. + Proven track record of resilience in the face of challenges. **Supervisory Responsibilities:**… more
- Novo Nordisk Inc. (Buffalo, NY)
- …level impact Demonstrates understanding of the local payer market including Medicare , Commercial and Medicaid benefit designs, Payer Coverage, Prescription Coverage ... Vehicle Records. Qualifications Bachelor's or equivalent egree, and/or Pharm D required Minimum one (1) year of experience working...be provided during the recruitment process. This position is part of a job family. Title and level within… more
- Commonwealth Care Alliance (Boston, MA)
- …management, (c) coordination of onboarding and training of related CBO staff, ( d ) data review, reporting and analysis, and (e)assistance to these external partners ... and databases that CCA implements. - Working knowledge of Medicare and Medicaid (MassHealth) - Familiarity with and full...self-motivated, with the ability to work independently and as part of a team to meet departmental goals. -… more
- US Physical Therapy (Houston, TX)
- …referral sources, while attracting top talent who value the chance to be part of a personalized, community-centered environment. **Job Description** We are seeking a ... Review denial trends + Financial Class determination + Update Medicare Expected Amounts Annually + Review and update state...Time Off. We are an Equal Opportunity Employer - M/F/ D /V We are proud to be an equal opportunity… more
- Excellus BlueCross BlueShield (Rochester, NY)
- …Description: This pharmacist clinician is a program manager, who is responsible for all Medicare Part D formulary creation and submissions, which includes ... for the current and upcoming contract years. This individual creates and executes the Medicare Part D formulary, delivering value and quality to the Plan's … more
- US Tech Solutions (May, OK)
- …06+ months contract **Note:** + Ideal candidates must have experience of Prior Authorization, Medicare Part D and Pharmacy Benefit Management experience. + ... **Job Description:** + As a Pharmacist Advisor you will be directly supporting Medicare Part D members and providers with requests related to their pharmacy… more
- CVS Health (Chicago, IL)
- …role is primarily responsible for modeling pharmacy network contracting arrangements for Aetna's Medicare Part D business and providing actuarial support to ... financial projections/modeling. + Support development of pharmacy network assumptions for Aetna's Medicare Part D bids and forecasts. + Partner with the… more
- Prime Therapeutics (Salem, OR)
- …cost effective delivery of service; design, develop, and implement annual operating budget and the Medicare Part D annual bid + Partner with stakeholders and ... healthcare industry and recognition for government program expertise; strong understanding of Medicare Part C and D rules and regulations + Exceptional… more
- Corewell Health (Grand Rapids, MI)
- …adherence + Educate members on disease state and medication + Educate members on Medicare Part D benefits and drug coverage to increase understanding ... Pharmacy Intern, under the direct supervision of a licensed Medicare Quality pharmacist, will engage with Medicare ...licensed Medicare Quality pharmacist, will engage with Medicare members to improve medication adherence to Medicare… more
- CVS Health (Hartford, CT)
- …and member/nonparticipating providers). * Provide direct support to appeal nurses and dedicated Medicare part D pharmacists; supervision and participation in ... **Responsibilities of this Medical Director role are related to Medicare Appeals:** * Direct daily work on part...Management Strategy support * Develop subject matter expertise on Medicare policy for the enterprise * Provide ongoing education… more
- US Tech Solutions (May, OK)
- …HAVE 6 months of experienced with Prior Authorization(required). + MUST HAVE experience with Medicare Part D + Must Have Pharmacy Benefit Management (PBM) ... experience. **Education:** + Pharm D . required with at least two years' experience as a pharmacist in Managed care environment. + Must have an active license in the… more
- Blue Cross Blue Shield of Massachusetts (Hingham, MA)
- …members Education and Experience: + Minimum 2-3 years of customer/member service experience + Medicare Part D and/or Pharmacy experience preferred + BS/BA or ... by visiting our Company Culture (https://careers.bluecrossma.org/us/en/culturepage) page. If this sounds like something you' d like to be a part of, we' d love… more
- Centers for Medicare & Medicaid Services (Washington, DC)
- …and support on Medicare Part B and D prescription drug models, Medicare Part D operational activities, and/or Medicare Part D ... Research Analyst, GS-0101-14, you will provide technical expertise and guidance on Medicare Part B and D policy and payment issues; develop innovative… more
- Humana (Lincoln, NE)
- …Policies and Procedures, and clinical literature as appropriate. Medical Directors will learn Medicare Part D and Medicare Advantage requirements ... first** The Medical Director relies on broad clinical expertise to review Medicare drug appeals ( Part D & B). The Medical director work assignments involve… more
- Rhythm Pharmaceuticals (Boston, MA)
- …appropriate access and coverage for Rhythm's portfolio across key commercial self-insured employers and Medicare Part D payers. The Senior NAD will develop ... of payer engagement and strategic account management in the commercial self-insured and/or Medicare Part D channels. The position reports into the VP, Market… 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
- US Tech Solutions (AZ)
- …months contract** **Job Description:** + As an RPh Advisor you will be directly supporting Medicare Part D members and providers with requests related to ... by reviewing information and completing timely and accurate documentation of all Medicare Part D requests, in compliance with Medicare guidelines,… more
- US Tech Solutions (May, OK)
- …availability could be required. **Experience:** + Prior authorization experience preferred. + Medicare Part D experience required + Previous pharmacy ... of experience although 2-5 years is preferred. **Skills:** + Prior Authorization + Medicare Part D **Education:** + Bachelor's Degree Required, Pharm D … more
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