- 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
- CVS Health (Hartford, CT)
- …Summary: Responsible for successful execution and delivery associated with leading large scale Medicare Part D product benefit implementation inclusive of ... experience coordinating pharmacy design builds and testing. + Minimum 3-5 years of solid Medicare Part D guidance & knowledge + Minimum 2 years Rx claims… more
- Humana (Columbus, OH)
- …data analytics skills and attention to detail **Preferred Qualifications** + Basic understanding of Medicare Part D + Prior experience with Microsoft Excel ... **Become a part of our caring community and help us...to a better quality of life for people with Medicare , Medicaid, families, individuals, military service personnel, and communities… more
- 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
- 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 (Austin, TX)
- …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
- 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
- CVS Health (Hartford, CT)
- …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
- Carle (Urbana, IL)
- …REQUIREMENTS Two (2) years experience in compliance or health insurance with previous Medicare Advantage, or Part D experience. SKILLS AND KNOWLEDGE ... Medicare Compliance Analyst - HYBRID + Department: HA...a Friend Save Save Apply Now Position Summary: The Medicare Compliance Analyst is responsible for understanding, researching, interpreting,… more
- CVS Health (Blue Bell, PA)
- …focus on developing cost trend projections and evaluating the drivers of emerging results for Medicare Part D - including MAPD, SNP, and PDP products. The ... 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)
- …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 (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
- Adecco US, Inc. (Woonsocket, RI)
- …geographic location and other factors. As an RPh Advisor you will be directly supporting Medicare Part D members and providers with requests related to their ... and ensuring accurate decisions that comply with compendia and Medicare guidance and timelines. + Ensure accuracy of case...be considered:** + Bachelor's degree in pharmacy or Pharm D . a + At least two years' experience as… more
- Vera Therapeutics (Brisbane, CA)
- …national (Centers for Medicare & Medicaid Services [CMS]), Medicaid (state and managed), Medicare Part D drug plans, key third party commercial payers, ... knowledge in obtaining reimbursement with third party commercial payers, Medicare Parts D and/or B, Medicaid, VA/DOD,...and experience. At Vera, base pay is only one part of your total compensation package. The successful candidate… more
- Convey Health Solutions (Fort Lauderdale, FL)
- …* Experience in a Medicare Advantage healthcare operations environment working with Medicare Part D (preferred). Knowledge, Skills, and Abilities * ... to drive effective change. A subject matter expert in Medicare processes, the manager ensures services align with client...engagement activities to include wellness sponsored events are a part of our inclusive and diverse culture Equal Opportunity… more
- The Arc Erie County NY (Williamsville, NY)
- …limits. + Work closely with pharmacies/doctor offices to make sure prescriptions are covered under Medicare Part D . If not covered, assist with searches for ... including, but not limited to, SSI, Social Security Assistance, Medicare , food stamps, and health insurance. This position is...opportunity to work remotely as well as being a part of a dynamic, engaging, & fun team! See… more
- VNS Health (Manhattan, NY)
- …resolve discrepancies to reduce financial and compliance risks to the plan. + Monitors Medicare Part D Reconciliation activities related to Prescription Drug ... issues (ie Medicaid status, state and county code discrepancies, Medicare status and changes, etc.). Follows up with departmental...community. When you join VNS Health, you become a part of something bigger. For generations, we've been a… 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 through ... where needed. **Responsibilities:** Utilizing multiple software systems to complete Medicare appeals case reviews Meeting or exceeding government mandated timelines… 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 through ... where needed. **Responsibilities:** + Utilizing multiple software systems to complete Medicare appeals case reviews + Meeting or exceeding government mandated… more
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