- CVS Health (Hartford, CT)
- …Summary: Responsible for successful execution and delivery associated with leading large scale Medicare Part D product benefit implementation inclusive of ... Bring your heart to CVS Health . Every one of us at CVS ...builds and testing. + Minimum 3-5 years of solid Medicare Part D guidance &...+ Minimum 3-5 years of solid Medicare Part D guidance & knowledge + Minimum… 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 put health first** The Actuarial Analyst 1, Pricing is responsible for setting pricing assumptions,… more
- CVS Health (Hartford, CT)
- Bring your heart to CVS Health . Every one of us at CVS ...Determination & Appeals experience. - 1 plus year of Medicare PART B experience - MHK, RxClaim, ... purpose: Bringing our heart to every moment of your health . This purpose guides our commitment to deliver enhanced...This purpose guides our commitment to deliver enhanced human-centric health care for a rapidly changing world. Anchored in… 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
- Medical Mutual of Ohio (OH)
- …a fully remote opportunity_** . **_Eastern & Central Time Zones preferred. Extensive Medicare Part D experience is highly sought after._** ... to moderately complex daily operations in compliance with 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
- Elevance Health (Columbus, OH)
- …of developing, preserving and deepening relationships with clients which include Elevance Health Medicare Health Plans. This position, structured around ... A proud member of the Elevance Health family of companies, CarelonRx (formerly IngenioRx) leverages...-Understanding of the benefit design and formularies, specifically for Part D . -Experience in a pharmacy benefit… more
- Sharp HealthCare (San Diego, CA)
- …process setting. Or 3 Years experience with managed care, PBM, Medicare Part D , Medicaid, or Commercial Health Insurance. + California Pharmacy ... is expected to work effectively and constructively with all health care team members. **Required Qualifications** + HS Diploma...aimed to reducing overall financial burden on patient and health system while maintaining highest quality of care. +… more
- Banner Health (AR)
- …8:00 AM - 5:00 PM (AZ Time). In this position you will be monitoring Medicare Advantage Parts C & D operational control measures ensuring appropriate oversight ... is in place for accurate, complete, and compliant for Medicare Advantage Parts C & D . +...experience. Requires knowledge of laws and regulations pertaining to health care, regulatory compliance, Medicare /Medicaid and/or financial… 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 ... based anywhere in the US.** Responsibilities of this Medical Director role are related to Medicare Appeals. * Direct daily work on part C appeals (both provider… more
- Carle (Urbana, IL)
- …Two (2) years experience in compliance or health insurance with previous Medicare Advantage, or Part D experience. SKILLS AND KNOWLEDGE Knowledge ... and guidance, and serves as the subject matter expert to Health Alliance staff on Medicare laws, regulations and CMS guidelines. + Implements tasks/action plans… more
- Centene Corporation (Raleigh, NC)
- …in Managed Care/ Health Insurance/Public Health / Health Care Administration/ Medicare Part D or related field required. + Some experience ... one who changes everything for our 28 million members. Centene is transforming the health of our communities, one person at a time. As a diversified, national… more
- The Cigna Group (Houston, TX)
- …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
- CVS Health (Hartford, CT)
- …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 (Blue Bell, PA)
- Bring your heart to CVS Health . Every one of us at CVS ...projections and evaluating the drivers of emerging results for Medicare Part D - including ... purpose: Bringing our heart to every moment of your health . This purpose guides our commitment to deliver enhanced...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
- 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
- CVS Health (Solon, OH)
- …Developer with a strong emphasis on front-end development to join our team at CVS Health Medicare Part D Systems. The ideal candidate will have extensive ... Bring your heart to CVS Health . Every one of us at CVS Health shares a single, clear purpose: Bringing our heart to every moment of your health . This purpose… more
- Sanofi Group (Cambridge, MA)
- …+ Responsible for the management and development of Medicare Part D , Managed Medicaid, and Commercial health plan contract documents, as well as ... + Detailed understanding, review and negotiating of contract language for Medicare Part D , Managed Medicaid, and Commercial health plan contracts (eg… more
- G-TECH Services, Inc. (Detroit, MI)
- …dashboard. * Assist with all functions related to Pharmacy Benefit Manager (PBM) oversight for Medicare Advantage Part D plans. * Receive and respond to plan ... projects for senior management. Bachelor's Degree in Business Administration, Health Care, or a related field is preferred. Two...Required Skills * Working knowledge of Medicare Part B and Part D … more