- GEHA (Lee's Summit, MO)
- …a personalized customer experience, sustained by a nimble and efficient organization. The Medicare Part D Performance Management Specialist will report to ... GEHA (Government Employees Health Association, Inc., pronounced GEHA) is a nonprofit...for monitoring contractual, operational, reporting, and regulatory requirements for Medicare Part D / EGWP… more
- 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...and Blue Shield of North Carolina (Blue Cross NC). Health care is changing, and we're leading the way.… more
- Healthfirst (NY)
- … Medicare Clinical Programming and Operations, Provider Performance, Medical and Pharmacy Part D cost savings, and Medicare Star Ratings/member ... finance, clinical, medical economics, operations, risk adjustment, and population health strategy to implement Medicare strategies and...and Operations + Provider performance + Medical and Pharmacy Part D cost savings + Medicare… more
- CVS Health (Blue Bell, PA)
- …+ Solid technical/analytical skills and attention to detail Preferred Qualifications + Previous Pharmacy, Medicare Part D , Medicare experience + ASA or ... Bring your heart to CVS Health . Every one of us at CVS ...financial and business impacts of changes to the complex Part D market and completive landscape. The… more
- 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 ... Actuarial team members to enhance actuarial knowledge + Monitor the Health Policy environment considering the implication of organization pricing policies, law,… more
- VNS Health (Manhattan, NY)
- … Plans product lines - Managed Long Term Care (MLTC), Medicare Advantage (MA), Part D , or Select Health to ensure compliance with mandated regulatory ... Plans product lines - Managed Long Term Care (MLTC), Medicare Advantage (MA) or Select Health . Ensures...in the home and community. When you join VNS Health , you become a part of something… more
- Centene Corporation (Phoenix, AZ)
- … Medicare Part D / Part B, Appeals, Medicare Part D Operations and State Health Programs Pharmacy Operations or Prior Authorization. Using ... million members as a clinical professional on our Medical Management/ Health Services team. Centene is a diversified, national organization...Regional Medical Director on related issues. + Prior Authorization Medicare Part D and … more
- 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.... 4 - 5 years of experience in a health plan, pharmacy, or PBM operations, which includes exposure… more
- Walworth County (Elkhorn, WI)
- …This position is responsible for assisting Medicare beneficiaries with enrollment issues regarding Medicare Part D , Medicare Part C (Advantage ... Elkhorn, WI Job Type Casual Job Number 2021-00139 Department Health & Human Services Division Aging & Disability Resource...or restrict the tasks that may be assigned. Perform Medicare Part D drug assessments… more
- CVS Health (Harrisburg, PA)
- …Managed Care experience in health plan and/or PBM roles 15+ years Medicare experience **Education** Pharmacist, BS or Pharm D with active, unrestricted ... formulation, implementation and milestone tracking for business plans as Part of the Medicare benefit and product...**Required Qualifications** 10+ years of Managed Care experience in health plan and/or PBM roles 10+ years Medicare… more
- CVS Health (Chicago, IL)
- …working in a fast-paced environment with constant change Preferred Qualifications + Prior Pharmacy, Medicare Part D , Medicare or Medicaid experience + ... and affordable. Join a high-performing actuarial team supporting CVS Health and Aetna's Government Services Medicare Advantage...position will provide modelling and analytical support for the Part D Business, with a focus on… more
- CVS Health (Chicago, IL)
- …PDP Products. This role will focus on developing health care solutions for Medicare Part D members. The colleague provides actuarial support to ensure ... Bring your heart to CVS Health . Every one of us at CVS ...attention to detail Preferred Qualifications + Previous Pharmacy or Medicare Part D experience +… more
- Northwell Health (Westbury, NY)
- …Job Description Seeking RN - BSN or MSN candidates with a HCS- D - Home Care Coding Specialist-Diagnosis, COS-C Certificate for OASIS Specialist-Clinical. Conducts ... Home Health Resource Group (HHRG) Validation to ensure the diagnostic...the Medical Record. Job Responsibility + Audits and reviews Medicare /non- Medicare charts to ensure that proper standards… more
- 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
- 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 ... and timelines. Reviewing information and completing timely and accurate documentation of all Medicare Part D requests, in compliance with Medicare… more
- The Cigna Group (Tampa, FL)
- …Technician in the Stars Pharmacy Call Center will work within the Part D Medication Adherence area of the Cigna Medicare Stars department. The Star rating ... by working with the clinical pharmacy team, physicians, and resources within the Medicare Health Plan. Primary Responsibilities include but are not limited to:… more
- Central Maine Medical Center (Lewiston, ME)
- …staff and other department managers.c) Creates and sustains a culture of safety. d ) Leads and manages change effectively.e) Responds to change productively, promotes ... and behavior.k) Maintains awareness of professional standards for Nursing, ongoing health care policies and economics, maintains awareness of future trends and… more
- 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 ... (BFO), supporting the Midwest and MidAmerica markets of our Medicare Advantage business. We are seeking a creative and...to drive growth and profit for their markets. Prior health insurance is not required, but the ideal candidate… more
- Molina Healthcare (Detroit, MI)
- …RN license in the state of MI. This position will support our MMP (Medicaid Medicare Population) that is part of the Personal Care team. This position will ... integrated delivery of care across the continuum, including behavioral health and long-term care, for members with high need...package. Molina Healthcare is an Equal Opportunity Employer (EOE) M/F/ D /V. Pay Range: $23.76 - $51.49 / HOURLY *Actual… more
- 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 ... company manages Medicare and Much More, a Medicare Advantage population health plan with a...their covered Part D drugs. Orlando Family Physicians, a...their covered Part D drugs. Orlando Family Physicians, a group of clinics… more