- 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 ... and tailor approach to customers Analyze bidding policies/contracts in order to influence formulary status, as applicable May analyze impact of managed care in the… more
- Excellus BlueCross BlueShield (Rochester, NY)
- …Job Description: This pharmacist clinician is a program manager, who is responsible for all Medicare Part D formulary creation and submissions, which ... for the current and upcoming contract years. This individual creates and executes the Medicare Part D formulary , delivering value and quality to the… more
- Rhythm Pharmaceuticals (Boston, MA)
- …experience required + Deep understanding of: + Medicare Part D landscape, including CMS regulations, PDPs/MA-PDs, and formulary decision-making and/or + ... access and coverage for Rhythm's portfolio across key commercial self-insured employers and Medicare Part D payers. The Senior NAD will develop and maintain… 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 ... information and completing timely and accurate documentation of all Medicare Part D requests, in...a Clinical decision regarding Prior Authorizations, Tier Exceptions and Non- Formulary requests (50%) + 6. Performs other related projects… 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 ... information and completing timely and accurate documentation of all Medicare Part D requests, in...a Clinical decision regarding Prior Authorizations, Tier Exceptions and Non- Formulary requests (50%) + Performs other related projects and… more
- Penn Medicine (Lancaster, PA)
- …care rounds , as a staff development education program, or as part of the hospital's interdisciplinary education program. + Support and assist interdepartmental ... Committee on the appropriate use of medications and or inclusion in the hospital formulary . + Interprets and evaluates all medication orders and assures for safe and… more
- Penn Medicine (Lancaster, PA)
- …patient care rounds), as a staff development education program, or as part of the hospital's interdisciplinary education program. + Support and assist ... Committee on the appropriate use of medications and/or inclusion in the hospital formulary . + Interprets and evaluates all medication orders and assures for safe and… more
- Novo Nordisk (Buffalo, NY)
- …impact + Demonstrates understanding of the local payer market including Medicare , Commercial and Medicaid benefit designs, Payer Coverage, Prescription Coverage ... customers + Analyze bidding policies/contracts in order to influence formulary status, as applicable + May analyze impact of...Records. Qualifications + Bachelor's or equivalent egree, and/or Pharm D required + Minimum one (1) year of experience… more
- Takeda Pharmaceuticals (Boston, MA)
- …system. Ensures the accuracy, integrity, and timeliness of all payments for Commercial and Medicare Part D contracted customers, including rebates, fees and ... as well as external parties including Payers and GPOs. + Supports all Commercial and Medicare Part D internal/external audits by preparing and providing the… more
- CVS Health (Topeka, KS)
- …on behalf of Elevance Health/CarelonRx across all lines of business (Commercial, Medicaid, Medicare Part D , etc.). In addition, the manager works ... with pharmacy contracts and contract-related documents, state and federal laws, Medicaid and Medicare Part D regulations. **Education** + Bachelor's degree… more
- United Therapeutics (LA)
- …Medicare & Medicaid Services (CMS) policies and processes with expertise in Medicare ( Part B and Part D ) Job Location This position will require ... awareness during the entire access process which may include formulary coverage/utilization management criteria, insurance forms & procedures, benefits… more
- Sanofi Group (Morristown, NJ)
- …+ Demonstrated experience in working in specialty pharmacy + Understanding of Commercial, Medicare Part D and Medicaid + Experience identifying trends ... to ensure the goal of profitable access. **About Sanofi:** We're an R& D -driven, AI-powered biopharma company committed to improving people's lives and delivering… more
