- 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... + Support vendor relationships (eg Plan Sponsor), daily operations , and implementation of EGWP pharmacy programs + Understand… more
- CVS Health (Hartford, CT)
- …- 3 plus year of Coverage Determination & Appeals experience. - 1 plus year of Medicare PART B experience - MHK, RxClaim, and People Safe proficient. - Meeting ... quality and productivity metrics in current role. **Education** High School Diploma or equivalent GED **Pay Range** The typical pay range for this role is: $17.00 - $31.30 This pay range represents the base hourly rate or base annual full-time salary for all… more
- Medical Mutual of Ohio (OH)
- …supervision, administers standardized to moderately complex daily operations in compliance with the Medicare Part D (pharmacy) and Medicare Part ... administers standardized to moderately complex daily operations in compliance with the Medicare Part D (pharmacy) and Medicare Part C (medical… more
- Elevance Health (Columbus, OH)
- … members. -Understanding of the benefit design and formularies, specifically for Part D . -Experience in a pharmacy benefit management organization leading ... member-centered, lasting pharmacy care. In this pivotal role on our CarelonRx Medicare Sales and Account Management team, the Pharmacy Account Director is tasked… more
- Central Maine Medical Center (Lewiston, ME)
- …the Nursing Director, the Nurse Leader is responsible for the day-to-day operations of assigned responsibilities and is accountable for assuring the consistent use ... 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… more
- Blue Cross Blue Shield of Massachusetts (Hingham, MA)
- …3. Support our Medicare Enrollment teams ( Medicare Advantage, Medex, and our Part D PDP teams) by cross training on other enrollment functions and assist ... by visiting our Company Culture (https://careers.bluecrossma.org/us/en/culturepage) page. If this sounds like something you' d like to be a part of, we' d love… more
- Catholic Health Initiatives (Bismarck, ND)
- …basis as required for Medicare Part B and Medicare Part D . + Actively participates in retail pharmacy operations . + Maintaining confidentiality ... throughout western and central North Dakota. CHI St. Alexius Health is part of CommonSpirit Health, a nonprofit, Catholic health system dedicated to advancing… more
- Bayer (Whippany, NJ)
- …free trial programs, eVouchers and inventory management; + Strong understanding of CMS, Medicare Parts A, B, and D , commercial payers, and legislative/policy ... there's only one choice.** **Director Patient Support Services Strategy Operations ** The Director Patient Support Services Strategy Operations...better life, we encourage you to apply now. Be part of something bigger. Be you. Be Bayer. To… more
- Blue Cross Blue Shield of Massachusetts (Hingham, MA)
- …pharmacy benefit interpretation, Medical Policy interpretation, and plan design interpretation. + Support Medicare Part D and understanding of CMS guidelines ... by visiting our Company Culture (https://careers.bluecrossma.org/us/en/culturepage) page. If this sounds like something you' d like to be a part of, we' d love… more
- Humana (Columbus, OH)
- …state relationship management, optimizing Medicaid performance and ensuring alignment with Medicare and other Enterprise leaders. **Unified D -SNP Market ... **Become a part of our caring community and help us...role will ensure consistent and aligned strategic execution, market operations , and best practice adoption across all Medicaid markets.… more
- Convey Health Solutions (Fort Lauderdale, FL)
- …in a Medicare Advantage healthcare operations environment working with Medicare Part D (preferred). Knowledge, Skills, and Abilities * Exceptional ... innovative solutions to drive effective change. A subject matter expert in Medicare processes, the manager ensures services align with client goals and regulatory… more
- Marshfield Clinic (Eau Claire, WI)
- …Service Line Medical Director - Hematology/Oncology **Cost Center:** 301081251 Systems Operations **Scheduled Weekly Hours:** 4 **Time Type:** Part time ... service line physicians c. Annual review of Advanced Practice Clinicians d . Market share/specialty planning, including outreach e. Budget and financial performance… more
- AdventHealth (Rome, GA)
- …+ Career Development + **Our promise to you:** Joining AdventHealth is about being part of something bigger. It's about belonging to a community that believes in the ... the delivery of patient care services, including but not limited to Medicare , Managed care, Medicaid, third-party providers, challenges to current health care… more
- Walgreens (Deerfield, IL)
- …able to address/understand/discuss complex reimbursement systems and flow of the healthcare dollar ( Medicare Part B/ D , ACOs, GPOs, Hospitals, etc.). **This ... variety of tools, and internal resources as an integral part of the sales interaction. + Leads cross functional...experience with billing procedures for hospital, medical offices and Medicare (B / D benefits). + Experience… 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 ... candidates with a Master's Degree). + Demonstrated knowledge of operations , with a working knowledge of Medicare ...community. When you join VNS Health, you become a part of something bigger. For generations, we've been a… more
- Molina Healthcare (Owensboro, KY)
- …& legal processes (Commercial insurance, Medicare , Medicare Advantage, Medicare Part D , Medicaid, Tricare, Pharmacy, etc.) + Experience ... in the group health business preferred, particularly within claims processing or operations . + A demonstrated working knowledge of Local, State & Federal laws… more
- CVS Health (Blue Bell, PA)
- …make health care more personal, convenient and affordable. **Position Summary:** Join the Aetna Medicare Part D Actuarial Team as the enterprise embarks on ... the creation of tools and models used by Aetna's Medicare Part D pricing processes...enable solutions for analytics, data management, business intelligence, business operations and actuarial science **Required Qualifications:** + 5+ years… more
- BrightSpring Health Services (Louisville, KY)
- …MOR, Sales, Key Strategic Operational changes, etc. + Assist with Member reconciliation, Part D Recon, LIS tracking, Rebate tracking, Claim subrogation, and ... Medical Services company, Population Health Management services company, and a Medicare Advantage Institutional Special Needs Plan (I-SNP).Under the direction of the… more
- VNS Health (Manhattan, NY)
- …one of the following VNS Health Plans product lines - Managed Long Term Care (MLTC), Medicare Advantage (MA), Part D , or Select Health to ensure compliance ... Plans product lines - Managed Long Term Care (MLTC), Medicare Advantage (MA) or Select Health. Ensures compliance with...analysis and reporting of grievances and appeals data for operations and for required CMS and DOH reporting. Participates… more
- Silicon Valley Power (Santa Clara, CA)
- …b. Transmission & Distribution Design & Construction c. Transmission & Distribution Operations & Maintenance d . Generation Design & Construction e. Generation ... Utility Engineer candidates to fill three (3) vacancies in the Utility Operations division and Customer Development and Project Management division. The ideal… more