• Manager of Medicare Part D

    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
    KPH Healthcare Services, Inc. (08/30/24)
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  • Medicare Pharmacy Coordinator

    Medical Mutual of Ohio (OH)
    …a fully remote opportunity_** . **_Eastern & Central Time Zones preferred. Extensive Medicare Part D experience is highly sought after._** ... supervision, administers standardized to moderately complex daily operations in compliance with the Medicare Part D (pharmacy) and Medicare Part C… more
    Medical Mutual of Ohio (09/20/24)
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  • Medicare Specialist (HHS)

    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
    Walworth County (10/12/24)
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  • Medicare Compliance Officer

    Dignity Health (Phoenix, AZ)
    …the regulatory compliance program for both Medicare Advantage ( Part C) and Medicare Part - D plan activities for Mercy Care Plan. Mercy Care Plan is ... Develops and monitors the implementation of and compliance with Medicare policies and procedures through the creation and implementation...can receive up to $18,000 over five years, while part -time employees can receive up to $9,000. While you're… more
    Dignity Health (11/08/24)
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  • Pharmacist Medicare

    Corewell Health (Grand Rapids, MI)
    …Disease (SPC), Medication Therapy Management (MTM), and CAHPS + Educate patients on their Medicare Part D benefits and drug coverage to increase ... Job Summary The Medicare Clinical Pharmacist will work with the ...Power Point + Ability to work independently and as part of a team + Comfortable with change +… more
    Corewell Health (11/22/24)
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  • Medical Director - Medicare Appeals

    CVS Health (Salem, OR)
    …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
    CVS Health (11/02/24)
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  • Senior Medicare Communications Compliance…

    Centene Corporation (Raleigh, NC)
    …+ 5+ years of experience in Managed Care/Health Insurance/Public Health/Health Care Administration/ Medicare Part D or related field required. + Some ... anywhere in the Continental United States.** **Position Purpose:** Supports the Medicare Communications Compliance team in the management of regulatory requirements… more
    Centene Corporation (11/22/24)
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  • Prior Authorization Specialist - MED D

    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
    US Tech Solutions (10/18/24)
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  • Clinical Pharmacist Advisor

    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 (10/18/24)
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  • Pharmacist

    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 (10/18/24)
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  • Operations Specialist

    Centers for Medicare & Medicaid Services (Woodlawn, MD)
    …also allow Medicare to negotiate prescription drug prices, implement improvements to Medicare Part D including a benefit redesign and new manufacturer ... Department of Health & Human Services (HHS), Centers for Medicare & Medicaid Services (CMS), Center for Medicare...discount program, impose inflation rebates for Part B and Part D more
    Centers for Medicare & Medicaid Services (11/21/24)
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  • Director, Corporate Accounts

    Mitsubishi Chemical Group (Jersey City, NJ)
    …of business. + Develop, refine, implement, and pull through the MTPA contracting strategy for Medicare Part D , PBMs, GPOs and Commercial + Manage all Payer ... customers and external groups including Commercial Payers, Medicare , Medicare Advantage plans, Part D , PBM's, GPOs, Commercial, FFS Medicaid, and Managed… more
    Mitsubishi Chemical Group (11/12/24)
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  • Data Science Analyst I-Geriatric and Palliative…

    Mount Sinai Health System (New York, NY)
    …8. Provides technical assistance to others in the department using Medicare claims data, Medicare Part D data and MDS data 9. May participate in the ... 1. Manages longitudinal claims data, including Medicare Carrier file and medication ( Part D ) data, as well as Minimum Data Set (MDS) for Nursing Homes and… more
    Mount Sinai Health System (10/17/24)
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  • Clinical Financial Consultant

    Trinity Health (Muskegon, MI)
    …opportunities specifically for patients enrolled in Marketplace policies, Medicare and Medicare part D . + Proactively enrolls all qualifying patients ... medical field working with the financial needs of patients. Experience with Medicare health plans, COBRA regulations, Affordable Care Act Marketplace Plans, Medicaid… more
    Trinity Health (11/26/24)
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  • Associate Actuary

    Humana (Columbus, OH)
    …on continuously improving consumer experiences **Preferred Qualifications** + Experience in SAS + Medicare Part D experience **Scheduled Weekly Hours** 40 ... role is a role within the Insurance Products Actuarial Medicare Advantage Prescription Drug Pricing team (focused on Individual...for ad hoc projects and analysis to help enhance Part D accuracy. The Associate Actuary, Pricing… more
    Humana (11/22/24)
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  • Medication and Pharmaceutical Policy Analyst

    American Institutes for Research (Rockville, MD)
    …related experience or Pharm. D . Degree. + Extensive familiarity with CMS, the ACA, Medicare Part D , and Medicare -specific value-based care policy and ... related to AIR Health's work with the Centers for Medicare & Medicaid Services (CMS). In addition, the candidate...NOTICE: If you need a reasonable accommodation for any part of the employment process due to a physical… more
    American Institutes for Research (11/16/24)
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  • Investigator, Coding SIU (Remote)

    Molina Healthcare (KY)
    …& legal processes (Commercial insurance, Medicare , Medicare Advantage, Medicare Part D , Medicaid, Tricare, Pharmacy, etc.) + Experience ... and compensation package. Molina Healthcare is an Equal Opportunity Employer (EOE) M/F/ D /V. Pay Range: $21.82 - $51.06 / HOURLY *Actual compensation may vary… more
    Molina Healthcare (11/06/24)
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  • Representative I

    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 through ... where needed. **Responsibilities:** Utilizing multiple software systems to complete Medicare appeals case reviews Meeting or exceeding government mandated timelines… more
    US Tech Solutions (10/18/24)
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  • Prior Authorization Specialist

    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 through ... where needed. **Responsibilities:** + Utilizing multiple software systems to complete Medicare appeals case reviews + Meeting or exceeding government mandated… more
    US Tech Solutions (10/18/24)
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  • Client Support Sr. Principal Government Programs…

    Prime Therapeutics (Columbus, OH)
    …skills including team leadership and collaboration + Understanding of Government Programs including Medicare , Part D , and Medicaid. + Demonstrated ability to ... of all GP client in-person events and virtual meetings, including annual all-client Medicare Star Rating and Bid forum. This person sets direction of GP client… more
    Prime Therapeutics (11/12/24)
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