• Medicare Part D Performance…

    GEHA (Lee's Summit, MO)
    …operational, reporting, and regulatory requirements for Medicare Part D / EGWP lines of business . **SKILLS** **Responsibilities:** + Serves as ... experience, sustained by a nimble and efficient organization. The Medicare Part D Performance Management...Pharmacy to align Medicare Part D / EGWP lines of business to… more
    GEHA (08/30/24)
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  • 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...client benefit. Aid internal teams to support clients and business partners. **Responsibilities** + Provide oversight of operational activities… more
    KPH Healthcare Services, Inc. (08/30/24)
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  • Consulting Actuary - Medicare Part

    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...evaluate risks and strategic opportunities involving Blue Cross NC's Medicare business through the deployment of actuarial… more
    BlueCross BlueShield of North Carolina (08/06/24)
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  • Senior Manager, Medicare Markets - Medical…

    Healthfirst (NY)
    Medicare Clinical Programming and Operations, Provider Performance, Medical and Pharmacy Part D cost savings, and Medicare Star Ratings/member ... areas of performance improvement opportunity and to make informed business decisions. + Leverages market and competitive intelligence reporting...and Operations + Provider performance + Medical and Pharmacy Part D cost savings + Medicare more
    Healthfirst (08/07/24)
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  • Actuary - Medicare Part D

    CVS Health (Blue Bell, PA)
    …market and completive landscape. The position will provide analytical and reporting support for the Part D Business , with a focus on pricing, modelling, and ... . This role will focus on analyzing financial and business impacts of changes to the complex Part...and attention to detail Preferred Qualifications + Previous Pharmacy, Medicare Part D , Medicare more
    CVS Health (08/31/24)
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  • Principal Actuary - Medicare Part

    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 ... concepts, and provide pricing support for all lines of business . This position will also lead complex projects that...healthcare organization or PBM + Previous experience pricing Commercial, Medicare or Medicaid lines of businesses + 5 years… more
    Prime Therapeutics (09/15/24)
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  • Medicare Pharmacy Coordinator

    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...Medicare Pharmacy Coordinator I** . Associate Degree in Business Administration, Healthcare, or related field or equivalent combination… more
    Medical Mutual of Ohio (09/20/24)
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  • Market Business Finance Officer (BFO)…

    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 ... Officer (BFO), supporting the Midwest and MidAmerica markets of our Medicare Advantage business . We are seeking a creative and strategic finance leader capable… more
    The Cigna Group (09/17/24)
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  • Lead Director, Product Mgt & Development…

    CVS Health (Harrisburg, PA)
    …Directs the formulation, implementation and milestone tracking for business plans as Part of the Medicare benefit and product cycle. Directs the strategic ... years of Managed Care experience in health plan and/or PBM roles 15+ years Medicare experience **Education** Pharmacist, BS or Pharm D with active, unrestricted… more
    CVS Health (09/19/24)
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  • Senior Actuary - Part D

    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 ... ensure business strategy achieve optimal outcomes within the ...attention to detail Preferred Qualifications + Previous Pharmacy or Medicare Part D experience +… more
    CVS Health (08/31/24)
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  • Senior Analyst; Part D Actuarial

    CVS Health (Chicago, IL)
    …Drug Plan business . The position will provide modelling and analytical support for the Part D Business , with a focus on pricing, modelling, and bid ... technical skills and critical thinking to design and achieve business solutions + Demonstrate understanding of existing data sources...environment with constant change Preferred Qualifications + Prior Pharmacy, Medicare Part D , Medicare more
    CVS Health (08/31/24)
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  • Compliance Manager of Risk Management & Oversight…

    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
    UCLA Health (08/15/24)
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  • Prior Authorization Specialist - MED D

    US Tech Solutions (May, OK)
    …requests for multiple clients or lines of business and in accordance with Medicare Part D CMS Regulations. + Must apply information provided through ... requires schedule flexibility and additional cross training to learn all lines of business . + Flexibility for movement to different parts of the business more
    US Tech Solutions (07/30/24)
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  • Care Manager - Temporary

    InnovaCare (San Juan, PR)
    …members, during and after natural disasters. Through the Florida MMM Line of Care, as a Part D sponsor, you will ensure that the member has adequate access to ... a conglomerate of companies that work on Puerto Rico's business strategies, both for Medicare Advantage beneficiaries,...their covered Part D drugs. Orlando Family Physicians, a… more
    InnovaCare (07/17/24)
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  • Physician

    InnovaCare (Guayama, PR)
    …members, during and after natural disasters. Through the Florida MMM Line of Care, as a Part D sponsor, you will ensure that the member has adequate access to ... a conglomerate of companies that work on Puerto Rico's business strategies, both for Medicare Advantage beneficiaries,...their covered Part D drugs. Orlando Family Physicians, a… more
    InnovaCare (07/17/24)
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  • Concurrent Review Nurse-( Auditor)- Metro, East,…

    InnovaCare (San Juan, PR)
    …members, during and after natural disasters. Through the Florida MMM Line of Care, as a Part D sponsor, you will ensure that the member has adequate access to ... a conglomerate of companies that work on Puerto Rico's business strategies, both for Medicare Advantage beneficiaries,...their covered Part D drugs. Orlando Family Physicians, a… more
    InnovaCare (07/17/24)
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  • Sales Promoter

    InnovaCare (Ponce, PR)
    …members, during and after natural disasters. Through the Florida MMM Line of Care, as a Part D sponsor, you will ensure that the member has adequate access to ... a conglomerate of companies that work on Puerto Rico's business strategies, both for Medicare Advantage beneficiaries,...their covered Part D drugs. Orlando Family Physicians, a… more
    InnovaCare (07/17/24)
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  • Quality Specialist Nurse

    InnovaCare (Ponce, PR)
    …members, during and after natural disasters. Through the Florida MMM Line of Care, as a Part D sponsor, you will ensure that the member has adequate access to ... a conglomerate of companies that work on Puerto Rico's business strategies, both for Medicare Advantage beneficiaries,...their covered Part D drugs. Orlando Family Physicians, a… more
    InnovaCare (07/17/24)
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  • Customer Service Rep - Temporary * Programa de…

    InnovaCare (San Juan, PR)
    …members, during and after natural disasters. Through the Florida MMM Line of Care, as a Part D sponsor, you will ensure that the member has adequate access to ... a conglomerate of companies that work on Puerto Rico's business strategies, both for Medicare Advantage beneficiaries,...their covered Part D drugs. Orlando Family Physicians, a… more
    InnovaCare (07/17/24)
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  • Customer Service Representative

    InnovaCare (Guaynabo, PR)
    …members, during and after natural disasters. Through the Florida MMM Line of Care, as a Part D sponsor, you will ensure that the member has adequate access to ... a conglomerate of companies that work on Puerto Rico's business strategies, both for Medicare Advantage beneficiaries,...their covered Part D drugs. Orlando Family Physicians, a… more
    InnovaCare (07/17/24)
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